Carroll, Kori L
Carroll, Kori L is an individual health care provider with primary practice located at 3105 Fields South Dr , Champaign IL 61822-3743. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Carroll, Kori L can be contacted via phone (217) 902-7527.Contact Information
Primary practice address
3105 Fields South Dr
Champaign IL 61822-3743
Phone: (217) 902-7527
Fax: (217) 902-7755
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 085001261 | Illinois |
Profile Details
| NPI number | 1598752628 |
|---|---|
| LBN Legal business name | Carroll, Kori L |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2005 |
| Last updated | Apr 23rd, 2019 - about 5 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.
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