Individual
MS. BREANNA JEAN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 N MCCORMICK BLVD, LINCOLNWOOD, IL 60712-2726
(888) 325-0862
Mailing address
6301 N SHERIDAN RD, APT 4V, CHICAGO, IL 60660-1728
(218) 348-4595
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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