Individual
COLLEEN M CANAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-2101
(618) 498-8153
Mailing address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-2101
(618) 498-8153
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000651
IL
Other
Enumeration date
07/15/2008
Last updated
09/21/2016
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