Provider Demographics
NPI:1154397248
Name:HUEBNER, COLLEEN (ATC, LAT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:HUEBNER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 GLENVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2538
Mailing Address - Country:US
Mailing Address - Phone:847-509-2608
Mailing Address - Fax:
Practice Address - Street 1:2300 SHERMER RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6722
Practice Address - Country:US
Practice Address - Phone:847-509-2608
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer