Individual
CAROLINE GRACE KORNAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(312) 766-4949
(312) 766-4908
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-008592
IL
363A00000X
Physician Assistant
085.008592
IL
363AM0700X
Medical Physician Assistant
085.008592
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2020
Last updated
01/30/2025
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