Carolyn Sue Loucks, LPN
Individual provider Active NPI Licensed Practical Nurse · Christopher, IL
NPI 1689735474 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689735474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- Practice address
- 4241 Hwy 14 W
Rea Clinic
Christopher, IL 62822 - Phone
- (618) 724-2401
- Fax
- (618) 724-2571
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043102044 | IL | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | IL | Yes |
Addresses
Primary practice location
4241 Hwy 14 W
Rea Clinic
Christopher, IL 62822
Mailing address
PO Box 155
Rea Clinic
Christopher, IL 62822
Phone (618) 724-2401
Other providers in Christopher, IL
- Kirks Pharmacy LLC
- Amanda B Kuberski
- Sarah Elizabeth Lee
- Jennifer Eason Linson
- Gayla Litton
- Melissa Diane Loyd
- Joy L Luster
- Apryl Lynn Malkovich
- Lana Malkovich
- Stephanie Maloney
All providers in Christopher, IL · Licensed Practical Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.