Provider Demographics
NPI:1043597131
Name:FOLKERS, COLLEEN MARIE (ANP-BC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARIE
Last Name:FOLKERS
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:MARIE
Other - Last Name:HERMANEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:845-PROFESSIONAL BUILDING
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-942-0600
Mailing Address - Fax:312-942-0601
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:845-PROFESSIONAL BUILDING
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-942-0600
Practice Address - Fax:312-942-0601
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.009204363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health