Basic Information
| Provider Information | |||||||||
| NPI: | 1629331277 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANZ | ||||||||
| FirstName: | COLIN | ||||||||
| MiddleName: | KLAUS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 355 E ERIE ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606113167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3122381000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 355 E ERIE ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3122381000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2012 | ||||||||
| LastUpdateDate: | 04/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 036-137332 | IL | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081N0008X | 036-137332 | IL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Neuromuscular Medicine |
ID Information
| ID | Type | State | Issuer | Description | 036137332 | 05 | IL | MEDICAID |