Fairbanks, Colleen Marie

Fairbanks, Colleen Marie is an sole proprietor health care provider with primary practice located at 9 N Main St 11, Lombard IL 60148-2300. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fairbanks, Colleen Marie can be contacted via phone (630) 903-3854.

Contact Information

Primary practice address
9 N Main St 11 Lombard IL 60148-2300
Phone: (630) 903-3854
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071.007621 Illinois

Profile Details

NPI number 1699914606
LBN Legal business name Fairbanks, Colleen Marie
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2009
Last updated Oct 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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