Mrs Colleen Dufour Martin, CRNA | |
701 W North Ave, Melrose Park, IL 60160-1612 | |
(847) 945-4550 | |
(847) 948-8103 |
Full Name | Mrs Colleen Dufour Martin |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 701 W North Ave, Melrose Park, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679718365 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 041.322892 (Illinois) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 209.007417 (Illinois) | Primary |
Entity Name | Shrewsbury Ambulatory Anesthesia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356691885 PECOS PAC ID: 4385899962 Enrollment ID: O20130305000423 |
Mailing Address | Practice Location Address |
---|---|
Mrs Colleen Dufour Martin, CRNA 1502 London Rd, New Lenox, IL 60451-9741 Ph: (732) 614-6759 | Mrs Colleen Dufour Martin, CRNA 701 W North Ave, Melrose Park, IL 60160-1612 Ph: (847) 945-4550 |
Tiffany Jean Vajda, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 | |
Andrew M Christ, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 | |
Petula M Sharma, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 | |
Arshnoor Aslam Qamaruddin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 | |
Dana Marie Macaluso, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 | |
Samuel Ortega, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 | |
Andrew Reichard, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 |