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Individual

BRENDA CARBAJAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12200 WESTERN AVE, BLUE ISLAND, IL 60406-1398
(708) 631-2781
Mailing address
1320 W LOMBARD ST, DAVENPORT, IA 52804-2029

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
09/18/2020
Last updated
03/14/2023
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