Individual
ILONA MARIE CARLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9054 COLUMBIA AVE STE B, MUNSTER, IN 46321-2905
(219) 703-2426
Mailing address
500 W SUPERIOR ST UNIT 1708, CHICAGO, IL 60654-8145
(312) 718-0263
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01082896A
IN
207V00000X
Obstetrics & Gynecology Physician
036101641
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630320
BCBS
—
05
—
036101641
—
IL
01
—
501046
ADVOCATE
—
Enumeration date
02/23/2007
Last updated
10/08/2020
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