NPI 1104210533

Arthur Dupree Carson, COTAL

Practitioner Adult Care Home Facility Glenview, IL

Practice location

Address: 3703 W Lake Ave STE 200, Glenview, IL 60026-1266
Phone: (847) 998-1188
Mailing address: 7653 S Bishop St APT 1s, Chicago, IL 60620-4126

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 057.000457 (IL)

Other Custodial Care Facility providers in Illinois →

Registry record

NPI: 1104210533
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Mar 2015
Record last updated: 24 Mar 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.