Provider Demographics
NPI:1881941698
Name:COLBY, TERRI ANNE (NP)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:ANNE
Last Name:COLBY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:ANNE
Other - Last Name:PAPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 MARTIN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6535
Mailing Address - Country:US
Mailing Address - Phone:630-600-0700
Mailing Address - Fax:630-600-0701
Practice Address - Street 1:10 MARTIN AVE STE 200
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6535
Practice Address - Country:US
Practice Address - Phone:630-600-0700
Practice Address - Fax:630-600-0701
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009083363L00000X
IL209.009083363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147OtherMEDICARE PTAN (GROUP)
IL206147140OtherMEDICARE PTAN (INDIVIDUAL)
IL206147140OtherMEDICARE PTAN (INDIVIDUAL)
ILF400141237Medicare PIN