Provider Demographics
NPI:1215042205
Name:CALONJE, GERMAN D (MD)
Entity type:Individual
Prefix:
First Name:GERMAN
Middle Name:D
Last Name:CALONJE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 BARRINGTON RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60194-1090
Mailing Address - Country:US
Mailing Address - Phone:847-755-1300
Mailing Address - Fax:847-755-1400
Practice Address - Street 1:1585 BARRINGTON RD
Practice Address - Street 2:SUITE 307
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1090
Practice Address - Country:US
Practice Address - Phone:847-755-1300
Practice Address - Fax:847-755-1400
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL201021240207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1635377OtherBLUE SHIELD
IL036111247Medicaid
ILI33251Medicare UPIN
IL1635377OtherBLUE SHIELD