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Organization

STEPHEN COULSON PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN ANDREW COULSON MD (PRESIDENT)
(847) 910-2850
Entity
Organization

Contact information

Practice address
1115 MARGATE LN, LIBERTYVILLE, IL 60048-2441
(847) 910-2850
Mailing address
1115 MARGATE LN, LIBERTYVILLE, IL 60048-2441
(847) 910-2850

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036098320
IL
208M00000X
Hospitalist Physician
036098320
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360983202
IL
Enumeration date
04/18/2013
Last updated
04/18/2013
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