Individual
CRISTIN COQUILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-2000
Mailing address
2177 S OVERLOOK RD, CLEVELAND HEIGHTS, OH 44106-3102
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
01096903A
IN
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036176055
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2018
Last updated
09/15/2025
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