Individual
COLLEEN A MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
250 E SUPERIOR ST FL 10, CHICAGO, IL 60611-2914
(312) 472-3776
(312) 472-4099
Mailing address
225 E CHICAGO AVE # 45, CHICAGO, IL 60611-2991
(773) 880-4142
(773) 880-3061
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036102036
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
ME167883
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102036
—
IL
Enumeration date
05/17/2006
Last updated
05/02/2024
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