Individual
JOSEPH S COLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 996-8177
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35086927
OH
207P00000X
Emergency Medicine Physician
Primary
36114380
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000383354
BCBS
OH
05
—
2621523
—
OH
Enumeration date
05/10/2006
Last updated
04/03/2024
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