Individual
MARY KATHERINE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
1333 W BELMONT AVE STE 200, CHICAGO, IL 60657-5785
(312) 926-3627
(312) 694-1885
Mailing address
1333 W BELMONT AVE STE 200, CHICAGO, IL 60657-5785
(312) 926-3627
(312) 694-1885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209030144
IL
363LF0000X
Family Nurse Practitioner
209030144
IL
Other
Enumeration date
07/15/2024
Last updated
12/05/2024
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