Colleen Bird, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001730 Issued in IL

Practice address

2631 Williamsburg Ave Ste 302
Geneva, IL 60134-1128

Phone

(630) 377-8500

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1356367601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606743269",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 WILLIAMSBURG AVE STE 302",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601341128",
            "telephone_number": "630-377-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "COLLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147103",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (PROVIDER PTAN)",
            "identifier": "P01209459",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (GROUPPTAN)",
            "identifier": "CA4748",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Maria Bidawid Uchiyama, PSY.D.
• Stan Biel, D.D.S., M.S.
• Roger A. Bielinski, M.D.
• Steven J. Bielski, M.D.
• Dean Paul Bieniak, PA-C
• Colleen M Blake, LCPC
• Sarah Lyn Bliss, LPC
• Blue Pearl Counseling LLC
• Kimberly Katherine Boatner, LCSW, CADC
• Jodi Lyn Boe, M.S., CCC/SLP

• Physician Assistant in Geneva, IL
• Providers in Geneva, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.