Individual
DR. KEVIN E COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
475 W. 55TH ST., SUITE 204, LAGRANGE, IL 60525-3566
(708) 354-5575
(708) 354-5504
Mailing address
475 W. 55TH ST., SUITE 204, LAGRANGE, IL 60525-3566
(708) 354-5575
(708) 354-5504
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1914819
IL
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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