Healthcare Provider Details

I. General information

NPI: 1316997208
Provider Name (Legal Business Name): CAROLLYN PIERARD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARI PIERARD APRN

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
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

Practice location:
  • Phone: 815-954-7221
  • Fax: 714-203-3539
Mailing address:
  • Phone: 815-954-7221
  • Fax: 714-203-3539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.000949
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209005560
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: