Provider Demographics
NPI:1619249711
Name:COLLADO, MARIA NOREEN (RPT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:NOREEN
Last Name:COLLADO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:MARIE
Other - Last Name:LARIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:183 N EAST RIVER RD
Mailing Address - Street 2:C5
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1251
Mailing Address - Country:US
Mailing Address - Phone:847-271-6408
Mailing Address - Fax:847-305-5886
Practice Address - Street 1:183 N EAST RIVER RD
Practice Address - Street 2:C5
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1251
Practice Address - Country:US
Practice Address - Phone:847-271-6408
Practice Address - Fax:847-305-5886
Is Sole Proprietor?:No
Enumeration Date:2012-02-04
Last Update Date:2012-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016523225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist