Individual
CAROLYN MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
656 N CONVENT ST STE C, BOURBONNAIS, IL 60914-1393
(815) 936-5167
Mailing address
656 N CONVENT ST STE C, BOURBONNAIS, IL 60914-1393
(815) 936-5167
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209025337
IL
Other
Enumeration date
07/11/2022
Last updated
03/05/2025
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