Provider Demographics
NPI:1518072255
Name:COLELLA, KATHLEEN M (ANP-BC, MSN, CURN)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:COLELLA
Suffix:
Gender:F
Credentials:ANP-BC, MSN, CURN
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Mailing Address - Street 1:1222 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-6716
Mailing Address - Country:US
Mailing Address - Phone:630-690-7486
Mailing Address - Fax:
Practice Address - Street 1:820 S DAMEN AVE
Practice Address - Street 2:UROLOGY CLINIC, JESSE BROWN VA MEDICAL CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3728
Practice Address - Country:US
Practice Address - Phone:312-569-8387
Practice Address - Fax:312-569-7253
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL163WU0100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WU0100XNursing Service ProvidersRegistered NurseUrology
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health