Colloton, Edward Leslie
Colloton, Edward Leslie is an individual health care provider with primary practice located at 1505 Eastland Dr Ste 2200, Bloomington IL 61701-7910. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Colloton, Edward Leslie can be contacted via phone (309) 662-7700.Contact Information
Primary practice address
1505 Eastland Dr Ste 2200
Bloomington IL 61701-7910
Phone: (309) 662-7700
Fax: (309) 662-0829
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | Illinois |
Profile Details
NPI number | 1023012614 |
---|---|
LBN Legal business name | Colloton, Edward Leslie |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 10th, 2005 |
Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1023012614 | NPPES |
Illinois | Other | 05700231 | BC/BS PROVIDER # |
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