Provider Demographics
NPI:1629700794
Name:DOLAN, COLIN CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:COLIN
Middle Name:CHRISTOPHER
Last Name:DOLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412027
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2027
Mailing Address - Country:US
Mailing Address - Phone:636-344-3333
Mailing Address - Fax:636-344-3334
Practice Address - Street 1:20 PROGRESS POINT PKWY
Practice Address - Street 2:STE 220
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2206
Practice Address - Country:US
Practice Address - Phone:636-344-3333
Practice Address - Fax:636-344-3334
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2023026689208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics