Provider Demographics
NPI:1144638461
Name:CHAPMAN, COLLEEN M (DPT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 TROY RD STE 120
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-2540
Mailing Address - Country:US
Mailing Address - Phone:618-800-4620
Mailing Address - Fax:618-200-4621
Practice Address - Street 1:2122 TROY RD STE 120
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-2540
Practice Address - Country:US
Practice Address - Phone:618-800-4620
Practice Address - Fax:618-200-4621
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic