Active NPI
Mary Ann Collins, MD
- Pediatrics Physician
- Chicago Ridge, IL
National Provider Identifier
1154473874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Practice address
- 10436 Southwest Highway
Chicago Ridge, IL 60415 - Phone
- (708) 636-0700
- Fax
- (708) 636-3849
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | IL | Primary |
Addresses
Primary practice location
10436 Southwest Highway
Chicago Ridge, IL 60415
Mailing address
10436 Southwest Highway
Chicago Ridge, IL 60415
Phone (708) 636-0700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036064441 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154473874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10436 SOUTHWEST HIGHWAY",
"city": "CHICAGO RIDGE",
"state": "IL",
"postal_code": "60415",
"telephone_number": "708-636-0700",
"fax_number": "708-636-3849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10436 SOUTHWEST HIGHWAY",
"city": "CHICAGO RIDGE",
"state": "IL",
"postal_code": "60415",
"telephone_number": "708-636-0700",
"fax_number": "708-636-3849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago Ridge, IL
- Chicago Ridge Radiology SC
- Chicago Ridge Radiology, S.C.
- Chicago Ridge School District
- Chicago Ridge Skilled Nursing Facility LLC
- Chicago Ridge SNF LLC
- Jerry Renato Coltro, M.D.
- Community Occupational Therapy
- Community Pharmacy of Chicago Ridge Inc
- Alayna Constance Corden, D.M.D.
- Core Anesthesia PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.