Individual
ELAM COALSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(312) 967-9820
Mailing address
937 E 54TH PL, CHICAGO, IL 60615-5050
(312) 967-9820
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/18/2020
Last updated
01/18/2020
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