Candace Jeanine Collins
Individual provider Active NPI Contractor · Chicago, IL
NPI 1457798860 · NPPES record last updated May 24, 2013
Key facts
- NPI
- 1457798860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 925 E 46TH St
Chicago, IL 60653-3638 - Phone
- (773) 343-3060
- NPI assigned
- May 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
925 E 46TH St
Chicago, IL 60653-3638
Mailing address
925 E 46TH St
Chicago, IL 60653-3638
Phone (773) 343-3060
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.