IndividualActive
Michael Coffman, IDC
NPI 1184883688 · Independent Duty Corpsman · Great Lakes, IL
Provider details
- NPI number
- 1184883688
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
601 D Street
Great Lakes, IL 60088-2822
Phone: (847) 688-4903
Approximate (ZIP-level) locationGet directions
Mailing address
601 D St
Great Lakes, IL 60088-2822
Registry dates
- Enumerated
- 2008-06-09
- Last updated
- 2008-06-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.