Carol Stream Medical PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CAROL STREAM MEDICAL PLLC

Practice address

270 W Army Trail Rd
Carol Stream, IL 60188

Phone

(630) 517-5674

NPI assigned

Oct 18, 2023

Last updated

Aug 27, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chanele Smith

Title

Manager

Phone

(239) 260-0530

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1851173330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 W ARMY TRAIL ROAD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601889368",
            "telephone_number": "630-246-7250",
            "fax_number": "630-332-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 W ARMY TRAIL RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "60188",
            "telephone_number": "630-517-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL STREAM MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-18",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHANELE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-260-0530"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caremaxdme LLC
• Caring Heavenly Hands (ComForcare Senior Service-Dupage)
• Imelda S Carlos, MD FAAP
• Carol Stream Dental Associates
• Carol Stream Fire Protection District
• Carol Stream Pharmacy P.C
• Carol Stream Vision Center
• John Thomas Carroll, M.D.
• Erica Carter
• Center for Personal Growth, PLLC

• General Practice Physician in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.