Individual
MS. EMILY MARIE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
325 IL ROUTE 2, DIXON, IL 61021-9118
(815) 284-6611
(815) 284-2834
Mailing address
325 IL ROUTE 2, DIXON, IL 61021-9118
(815) 284-6611
(815) 284-2834
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043121417
IL
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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