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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 13 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 1659656486 NPPES
Other 208341 GROUP PTAN
Other 208342 GROUP PTAN

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