Provider Demographics
NPI:1376645986
Name:COMBS, CATHERINE E (CNM)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:E
Last Name:COMBS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:E
Other - Last Name:LUCZAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4529 N ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-1534
Mailing Address - Country:US
Mailing Address - Phone:618-277-6668
Mailing Address - Fax:618-234-5230
Practice Address - Street 1:4529 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1534
Practice Address - Country:US
Practice Address - Phone:618-277-6668
Practice Address - Fax:618-234-5230
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041168892163W00000X
IL209002351367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse