Individual
PATRICK CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 E ILLINOIS ST APT 2802, CHICAGO, IL 60611-4516
(312) 219-1249
Mailing address
220 E ILLINOIS ST APT 1109, CHICAGO, IL 60611-4365
(312) 219-1249
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019029069
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12010982A
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
13207
CT
Other
Enumeration date
08/18/2007
Last updated
10/04/2021
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