Search › Illinois › 103TC0700X
Chad Drake
NPI 1891169629 · on the registry since 2015
Practice
- Address
- 625 Wham Dr
Room 141
Carbondale, IL 62901 - Phone
- (618) 453-2361
- Fax
- (618) 453-6130
- Organisation at this address
- Southern Illinois University Carbondale Clinical Center
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 103TC0700X
103TC0700X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-11-17
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