Individual
REBECCA L COOLIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
3506 OAKWOOD DR, ISLAND LAKE, IL 60042-9207
(847) 363-5811
Mailing address
3506 OAKWOOD DR, ISLAND LAKE, IL 60042-9207
(847) 363-5811
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
210-49
WI
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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