Individual
CARRIE H KALLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN APRN
Contact information
Practice address
390 MAPLE SUMMIT RD, ILLINI BLDG, JERSEYVILLE, IL 62052
(618) 498-2101
(618) 498-8153
Mailing address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-7518
(618) 498-3052
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209021821
IL
Other
Enumeration date
08/25/2020
Last updated
11/13/2024
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