Individual
SELINA M CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
45 TOWER CT STE C, GURNEE, IL 60031-3376
(847) 623-3200
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001976
IL
Other
Enumeration date
09/26/2006
Last updated
06/07/2022
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