Organization
THE FAIRBANKS GROUP
Active
Other names
Dr. Colleen M. Fairbanks, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLEEN MARIE FAIRBANKS PHD (LICENSED CLINICAL PSYCHOLOGIST)
(630) 903-3854
Entity
Organization
Contact information
Practice address
2625 BUTTERFIELD RD STE 103W, OAK BROOK, IL 60523-3418
(630) 903-3854
Mailing address
158 S CHARLOTTE ST, LOMBARD, IL 60148-2608
(630) 903-3854
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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