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NPI Code Detail

MEDICARE: DR. COLLEEN JOSEPH DNP, FNP-BC

MEDICARE: DR. COLLEEN JOSEPH DNP, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209013525IL
2363LF0000XFamily Nurse Practitioner209013525IL

General Provider Information

NPI Number : 1174982789
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COLLEEN JOSEPH DNP, FNP-BC
Provider Business Mailing Address
First Line : 245 W ROOSEVELT RD STE 150
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-4818
Country : US
Telephone Number : 866-267-2353
Fax Number :
Provider Business Practice Location Address
First Line : 245 W ROOSEVELT RD STE 150
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-4818
Country : US
Telephone Number : 866-267-2353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2016
Last Update Date : 11/10/2020

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Directions to “ DR. COLLEEN JOSEPH DNP, FNP-BC” Practice Location

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