Individual
JENNIFER COLELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1220 S WOOD ST, CHICAGO, IL 60608-1202
(312) 996-2000
Mailing address
1220 S WOOD ST, CHICAGO, IL 60608-1202
(312) 996-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209010920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209010920
STATE LICENSE
IL
Enumeration date
11/06/2013
Last updated
10/11/2016
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