Individual
CAROLINE COLSEN LOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-3329
(773) 834-8891
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006094
IL
363A00000X
Physician Assistant
3573-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811371479
NPI
—
Enumeration date
07/14/2015
Last updated
07/21/2022
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