Fant, Colleen D
Fant, Colleen D is an individual health care provider with primary practice located at 225 E Chicago Ave , Chicago IL 60611-2991. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Fant, Colleen D can be contacted via phone (800) 543-7362.Contact Information
Primary practice address
225 E Chicago Ave
Chicago IL 60611-2991
Phone: (800) 543-7362
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036140292 | Illinois |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | 036140292 | Illinois |
Profile Details
NPI number | 1891132049 |
---|---|
LBN Legal business name | Fant, Colleen D |
Credentials | MD, MPH |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 29th, 2013 |
Last updated | Oct 4th, 2019 - about 5 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 | 1891132049 | NPPES |
Illinois | MEDICAID | 036140292 |
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