Individual
COLLEEN R BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
2160 SOUTH FIRST AVE, LOYOLA UNIVERSITY MEDICAL CENTER, MAYWOOD, IL 60153
(888) 584-7888
Mailing address
PSC 2 BOX 8509, APO, AE 09012-0035
4915158832446
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.009841
IL
Other
Enumeration date
10/25/2012
Last updated
04/16/2026
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