Individual
EDGAR S CARELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
908 N ELM ST STE 404, HINSDALE, IL 60521-3638
(630) 789-3422
Mailing address
900 S FRONTAGE RD, SUITE 325, WOODRIDGE, IL 60517-4903
(630) 789-3422
(630) 789-9093
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036097519
IL
207RI0011X
Interventional Cardiology Physician
Primary
036-097519
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912218850
NPI GROUP PRACTICE
IL
01
—
IL4174002
MEDICARE-LOCALITY 16
IL
01
—
IL4177002
MEDICARE-LOCALITY 15
IL
Enumeration date
05/24/2006
Last updated
03/11/2021
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