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Individual

MARK K COLIP

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-3849
(312) 225-6200
(312) 949-7660
Mailing address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-3849
(312) 949-7410
(312) 949-7680

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203420
IL
Enumeration date
08/30/2005
Last updated
07/09/2007
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