Individual
CAROL L CORBRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1725 W HARRISON ST, SUITE 155, CHICAGO, IL 60612-3841
(312) 563-3269
(312) 563-3272
Mailing address
1725 W HARRISON ST, SUITE 155, CHICAGO, IL 60612-3841
(312) 563-3269
(312) 563-3272
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-071198
IL
2085R0202X
Diagnostic Radiology Physician
4301088781
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4931452
—
MI
Enumeration date
08/31/2006
Last updated
07/31/2009
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