Basic Information
| Provider Information | |||||||||
| NPI: | 1669907390 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHORNEY | ||||||||
| FirstName: | COLLETTE | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 435 S CRYSTAL ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | BUTTE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597011506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064693600 | ||||||||
| FaxNumber: | 4064963653 | ||||||||
| Practice Location | |||||||||
| Address1: | 435 S CRYSTAL ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | BUTTE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597011506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064693600 | ||||||||
| FaxNumber: | 4064963653 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2017 | ||||||||
| LastUpdateDate: | 11/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 70287-20 | WI | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 84013 | MT | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.