Individual
JOHNATHAN TODD COLEMAN
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
(866) 600-2273
Mailing address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 355-3016
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036134576
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2011
Last updated
01/19/2017
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