Individual
CHARLES ANTHONY CHARRIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11830 S KOMENSKY AVE APT 3B, ALSIP, IL 60803-1658
(708) 264-2240
Mailing address
11830 S KOMENSKY AVE APT 3B, ALSIP, IL 60803-1658
(708) 264-2240
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172616807
—
IL
Enumeration date
01/31/2023
Last updated
01/31/2023
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