Carcellar, Marie R
Carcellar, Marie R is an individual health care provider with primary practice located at 5101 S Willow Springs Rd , La Grange IL 60525-7009. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Carcellar, Marie R can be contacted via phone (708) 245-4073.Contact Information
Primary practice address
5101 S Willow Springs Rd
La Grange IL 60525-7009
Phone: (708) 245-4073
Fax: (708) 245-5614
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 209008874 | Illinois |
Profile Details
NPI number | 1659656486 |
---|---|
LBN Legal business name | Carcellar, Marie R |
Credentials | Certified Nurse Practitioner (CNP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 12th, 2011 |
Last updated | Feb 14th, 2013 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1659656486 | NPPES |
Other | 208341 | GROUP PTAN | |
Other | 208342 | GROUP PTAN |
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