Provider Demographics
NPI:1902919954
Name:COLLINS, YVONNE C (MD, FACOG)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:C
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 W 95TH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2600
Mailing Address - Country:US
Mailing Address - Phone:708-684-5630
Mailing Address - Fax:708-684-4949
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:SUITE
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-5630
Practice Address - Fax:708-684-4949
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-098675207VX0201X
IL036098675207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH96218Medicare UPIN
ILK27537Medicare ID - Type Unspecified