Healthcare Provider Details
I. General information
NPI: 1073266342
Provider Name (Legal Business Name): CARICARE MOBILE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 COALER DR
COAL CITY IL
60416-2445
US
IV. Provider business mailing address
317 COALER DR
COAL CITY IL
60416-2445
US
V. Phone/Fax
- Phone: 815-955-1723
- Fax:
- Phone: 815-955-1723
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAROLLYN
PIERARD
Title or Position: OWNER
Credential: NP
Phone: 815-954-7221