Provider Demographics
NPI:1235969726
Name:DURKAN, COLLEEN MARY
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARY
Last Name:DURKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 N OLIPHANT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1309
Mailing Address - Country:US
Mailing Address - Phone:773-573-5020
Mailing Address - Fax:
Practice Address - Street 1:6725 N OLIPHANT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1309
Practice Address - Country:US
Practice Address - Phone:773-573-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.007713235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist