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Individual

MRS. CARLY MANLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
525 E CONGRESS PKWY, CRYSTAL LAKE, IL 60014-6245
(815) 479-7490
(815) 455-2654
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.486742
IL
363LF0000X
Family Nurse Practitioner
Primary
209.028716
IL

Other

Enumeration date
10/25/2023
Last updated
04/30/2024
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