Colleena Sue Smith

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

152.000089 Issued in IL

Practice address

2990 N Perryville Rd Unit 1100
Rockford, IL 61107-6827

Phone

(815) 469-1500

NPI assigned

Mar 15, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Funtastic Gymnastic LLC

  • Behavior Analyst
  • Lombard, IL
  • NPI 1396078275
  NPD
• Westside Childrens Therapy

  • Physical Therapist
  • Joliet, IL
  • NPI 1972783900
  NPD (past)

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1851850242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 BORMET DR STE 304",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488399",
            "telephone_number": "815-469-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 N PERRYVILLE RD UNIT 1100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076827",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7177 Crimson Ridge Dr Ste 10",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611076235",
            "country_code": "US",
            "telephone_number": "847-465-9556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COLLEENA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "152.000089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Julienne Smith
• Brena Marie Smith, D.C.
• Cameron Joseph Smith, PHARMD
• Chandra Nicole Smith, FNP-C
• Chelsea Smith, FNP-BC
• Dwight Smith Jr.
• Erik John Smith
• Jeffrey R Smith, MD
• Jill Frances Smith
• Katera Smith

• Behavior Analyst in Rockford, IL
• Providers in Rockford, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.