Carmack, Leslie M.

Carmack, Leslie M. is an individual health care provider with primary practice located at 1701 E College Ave , Bloomington IL 61704-2101. 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. Carmack, Leslie M. can be contacted via phone (309) 664-3800.

Contact Information

Primary practice address
1701 E College Ave Bloomington IL 61704-2101
Phone: (309) 664-3800
Fax: (309) 664-3461
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209-007212 Illinois

Profile Details

NPI number 1073760716
LBN Legal business name Carmack, Leslie M.
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2008
Last updated Oct 6th, 2020 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073760716 NPPES
Illinois Other IL2613 MEDICARE GROUP PTAN
Illinois Other IL2613053 MEDICARE GROUP PTAN

Popular Providers