Provider Demographics
NPI:1629340070
Name:DINGES, COLLEEN MARY (LPN II, CST)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARY
Last Name:DINGES
Suffix:
Gender:F
Credentials:LPN II, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62629-1662
Mailing Address - Country:US
Mailing Address - Phone:217-685-8030
Mailing Address - Fax:
Practice Address - Street 1:6 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:IL
Practice Address - Zip Code:62629-1662
Practice Address - Country:US
Practice Address - Phone:217-685-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043.088240164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse