Basic Information
| Provider Information | |||||||||
| NPI: | 1962468363 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COATS | ||||||||
| FirstName: | TONYA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | CHICAGO HTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604111748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087560100 | ||||||||
| FaxNumber: | 7087096353 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | CHICAGO HTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604111748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087560100 | ||||||||
| FaxNumber: | 7087096353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.