Individual
COLLEEN M GRANDOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
21202 OWENS RD STE 101, MOKENA, IL 60448-2001
(779) 334-0030
(779) 334-0031
Mailing address
21202 OWENS RD STE 101, MOKENA, IL 60448-2001
(779) 334-0030
(779) 334-0031
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277000793
IL
363LA2100X
Acute Care Nurse Practitioner
209007785
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009006540
AMERICAN NURSES CREDENTIALING CENTER
IL
Enumeration date
10/23/2009
Last updated
01/17/2022
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