SearchIllinois103TS0200X

Carla Burdette

NPI 1437638624 · on the registry since 2018 · sole proprietor

Practice

Address
1805 Esic Dr
Edwardsville, IL 62025
Phone
(618) 973-6930

Registry record

Primary taxonomy
103TS0200X
103TS0200X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-08-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois