Colmed Clinic LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COLMED CLINIC LTD

Practice address

3615 N Ashland Ave Apt 1N
Chicago, IL 60613-4742

Phone

(773) 770-6300

Fax

(773) 665-5007

NPI assigned

May 6, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wayne Meyers

Title

Office Manager

Phone

(773) 770-6300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Colmed Clinic LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• HD Medspa & Clinic

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1194126573
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harold Rene Diaz, MD

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1508886409

  IL

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1194380147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 N ASHLAND AVE APT 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134742",
            "telephone_number": "773-770-6300",
            "fax_number": "773-665-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 N ASHLAND AVE APT 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134742",
            "telephone_number": "773-770-6300",
            "fax_number": "773-665-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLMED CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "MEYERS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "773-770-6300"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette Renee Collins, D.D.S.
• Danielle Collons, MD
• Kathryn L Colman, M.D.
• Lindsay Colman, RDN, LDN
• Matthew Wesley Colman, MD
• Michael Colombatto, PSY.D.
• Nicole Colon Quintana, MA
• Alina M Colon, MMS, PA-C
• Carmen Colon, CFO
• Jose Colon, MSW

• All providers in Chicago, IL
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.