Provider Demographics
NPI:1275506933
Name:JONES, COLLEEN E (CNM)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:E
Last Name:JONES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2972 INDIAN TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9408
Mailing Address - Country:US
Mailing Address - Phone:630-978-4800
Mailing Address - Fax:630-978-6791
Practice Address - Street 1:2972 INDIAN TRAIL, STE.
Practice Address - Street 2:SUITE A
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502
Practice Address - Country:US
Practice Address - Phone:630-978-4800
Practice Address - Fax:630-978-6791
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-222276367A00000X
IL209002482367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILS57502Medicare UPIN