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Individual

CAROL BALLOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
501 W OGDEN AVE STE 6, HINSDALE, IL 60521-3184
(630) 321-9590
(630) 920-0931
Mailing address
PO BOX 261, WESTERN SPRINGS, IL 60558-0261
(630) 321-9590
(630) 986-1477

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-058329
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022-26656
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/25/2006
Last updated
03/28/2015
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