Individual
THERESIA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1236 ASHLAND AVE, CHICAGO HEIGHTS, IL 60411-2544
(708) 444-1012
Mailing address
17746 OAK PARK AVE, TINLEY PARK, IL 60477-3936
(708) 444-1012
(708) 614-7831
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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