Healthcare Provider Details

I. General information

NPI: 1205743572
Provider Name (Legal Business Name): APRIL CARLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 N STATE ST
MARENGO IL
60152-2200
US

IV. Provider business mailing address

951 EMERALD DR
PINGREE GROVE IL
60140-9112
US

V. Phone/Fax

Practice location:
  • Phone: 815-261-8288
  • Fax:
Mailing address:
  • Phone: 773-981-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041401403
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: