Individual
CAROLYN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
75 REMITTANCE DR, SUITE 1293, CHICAGO, IL 60675-1293
(312) 926-4392
Mailing address
680 N LAKE SHORE DR, SUITE 818, CHICAGO, IL 60611-4546
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041235044
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041235044
LICENSE
IL
Enumeration date
01/22/2013
Last updated
01/22/2013
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