Individual
MR. CHARLES DOUGLAS CAMPBELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2018 217TH ST, SAUK VILLAGE, IL 60411-4521
(773) 283-1742
(773) 283-1742
Mailing address
4743 N KILBOURN AVE, CHICAGO, IL 60630-4006
(773) 283-1742
(773) 283-1742
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/11/2009
Last updated
09/11/2009
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