Provider Demographics
NPI:1497271571
Name:JAREMA, COLLEEN MINNIE (DPT, PT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MINNIE
Last Name:JAREMA
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:MINNIE
Other - Last Name:HALLINAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:1720 MAPLE AVE APT 1880
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-7003
Mailing Address - Country:US
Mailing Address - Phone:937-609-3320
Mailing Address - Fax:
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-20
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070023142225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist