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CHARITY ANNE CORBETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C-NP

Contact information

Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-1305
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1718

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209006606041312446
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209006606041312446
ILLINOIS STATE PRACTICE LICENSE - CERTIFIED NURSE PRACTITIONER
IL
Enumeration date
10/15/2009
Last updated
10/15/2009
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