Carlson, Wayne P

Carlson, Wayne P is an sole proprietor health care provider with primary practice located at 600 S Randall Rd , Algonquin IL 60102-5996. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Carlson, Wayne P can be contacted via phone (224) 783-4302.

Contact Information

Primary practice address
600 S Randall Rd Algonquin IL 60102-5996
Phone: (224) 783-4302
Fax: (224) 783-4356
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036064835 Illinois

Profile Details

NPI number 1629076005
LBN Legal business name Carlson, Wayne P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2005
Last updated Jun 13th, 2011 - about 15 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 1629076005 NPPES
Illinois MEDICAID 036064835
Illinois Other 05632414
Illinois Other 612038400
Illinois Other 05623112

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