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Individual

CAROLE C MORRISSEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2525 S MICHIGAN AVE, CHICAGO, IL 60616-2315
(312) 567-7945
(312) 567-6682
Mailing address
1920 S PRAIRIE AVE, CHICAGO, IL 60616-1321
(312) 842-7900

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
209000934
IL
363LF0000X
Family Nurse Practitioner
Primary
209000934
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041185842
RN LICENSE
IL
01
209000934
STATE LICENSE
IL
01
950150014
MEDICARE PTAN
IL
Enumeration date
04/18/2007
Last updated
05/27/2022
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