Individual
REBECCA J. COLLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 EAST CARPENTER STREET, ROOM 2K64, SPRINGFIELD, IL 62769-0001
(217) 525-5643
(217) 544-2521
Mailing address
800 EAST CARPENTER STREET, ROOM 2K64, SPRINGFIELD, IL 62769-0001
(217) 525-5643
(217) 544-2521
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041296376
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209005056
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041296376
IL LICENSE #
IL
01
—
0841504038
BCBS OF ILLINOIS
IL
01
—
209-005617
IL APN LICENSE #
IL
01
—
71431
AANA#
IL
01
—
L031806
CHAMPUS/TRICARE
IL
Enumeration date
10/13/2005
Last updated
10/16/2013
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