Individual
CAROLYN M CONAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
1051 W US ROUTE 6, SUITE 100, MORRIS, IL 60450-3349
(815) 942-4875
(815) 942-5046
Mailing address
1051 W US ROUTE 6, SUITE 100, MORRIS, IL 60450-3349
(815) 942-4875
(815) 942-5046
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04919
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085003271
IL STATE LICENSE
IL
01
—
PA04919
STATE LICENSE
TX
Enumeration date
08/11/2006
Last updated
03/07/2023
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