Provider Demographics
NPI:1932568193
Name:COLEMAN, DIONNE RENEE (APN)
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:RENEE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11108 S BELL AVE
Mailing Address - Street 2:APT 2S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-3947
Mailing Address - Country:US
Mailing Address - Phone:773-412-4108
Mailing Address - Fax:
Practice Address - Street 1:11108 S BELL AVE
Practice Address - Street 2:APT 2S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3947
Practice Address - Country:US
Practice Address - Phone:773-412-4108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily