Individual
MS. ALYSSA BENE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 MAIN ST STE 500A, PEORIA, IL 61606-2038
(309) 672-4980
(309) 672-2931
Mailing address
1001 MAIN ST STE 500A, PEORIA, IL 61606-2038
(309) 672-4980
(309) 672-2931
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008561
IL
Other
Enumeration date
05/13/2020
Last updated
08/17/2022
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