Waters, Carissa

Waters, Carissa is an sole proprietor health care provider with primary practice located at 836 W Wellington Ave , Chicago IL 60657-5147. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Waters, Carissa can be contacted via phone (773) 296-1295.

Contact Information

Primary practice address
836 W Wellington Ave Chicago IL 60657-5147
Phone: (773) 296-1295
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 364SA2100X 209015912 Illinois

Profile Details

NPI number 1700313202
LBN Legal business name Waters, Carissa
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 15th, 2017
Last updated May 15th, 2017 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1700313202 NPPES
Illinois Other 209015912 APN LICENSE

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