Provider Demographics
NPI:1740632058
Name:COLLETTA, LENA A (APRN-CNP)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:A
Last Name:COLLETTA
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 N WESTMORELAND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1671
Mailing Address - Country:US
Mailing Address - Phone:847-535-6083
Mailing Address - Fax:847-234-4336
Practice Address - Street 1:2150 PFINGSTEN RD STE 3000
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1314
Practice Address - Country:US
Practice Address - Phone:847-657-1900
Practice Address - Fax:847-657-1961
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209.014428363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner