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Individual

META CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1379
(630) 933-1602
Mailing address
225 E CHICAGO AVE # 62, CHICAGO, IL 60611-2991
(312) 227-6080
(312) 227-9475

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD26082
OR
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
MD00045233
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213677
OR
05
8431017
WA
Enumeration date
07/27/2006
Last updated
05/04/2022
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