Individual
MS. CARLETTE BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
9501 S KING DR, CHICAGO, IL 60628-1598
(773) 995-3992
Mailing address
1009 5TH AVE, HAMMOND, IN 46320
(219) 473-0722
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209017165
IL
Other
Enumeration date
09/23/2019
Last updated
02/29/2024
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