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Individual

CHARLES S COLODNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
716 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3225
(847) 362-1393
(847) 362-3797
Mailing address
716 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3225
(847) 362-1393
(847) 362-3797

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036057093
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036057093
IL
Enumeration date
08/15/2005
Last updated
07/08/2007
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