Provider Demographics
NPI:1952750143
Name:MAY, COLLEEN (BCBA)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:560 GREEN BAY RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:560 GREEN BAY RD
Practice Address - Street 2:SUITE 10
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093
Practice Address - Country:US
Practice Address - Phone:847-813-1096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-14-16821103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst