Individual
BETHZAIDA COLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10035 GRAND AVE FL 3, FRANKLIN PARK, IL 60131-2500
(847) 451-0330
(847) 451-0761
Mailing address
7019 W IRVING PARK RD APT 3, CHICAGO, IL 60634-2292
(787) 564-1348
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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