Individual
PHILLIP OZELL CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1408 S 10TH AVE, MAYWOOD, IL 60153-1957
(630) 999-1143
Mailing address
1408 S 10TH AVE, MAYWOOD, IL 60153-1957
(630) 999-1143
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209024649
IL
Other
Enumeration date
02/05/2022
Last updated
01/18/2024
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