Organization
ADVENTIST MIDWEST GERIATRICS SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE ROSE CARCELLAR APN (NURSE PRACTITIONER)
(708) 245-4073
Entity
Organization
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-4073
Mailing address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-4073
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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