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General NPI Number Information
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NPI Number | 1750827838
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Entity Type | Individual
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Provider Name | CARLIE RENEE TERCHIN APN
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Gender | Female
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 224 W CLARENDON DR
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City | ROUND LAKE BEACH
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State | IL
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Zip | 60073-1896
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Country | US
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Telephone | 847-377-8269
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Fax | 847-934-5689
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Provider Business Mailing Address
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Address Line | 224 W CLARENDON DR
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City | ROUND LAKE BEACH
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State | IL
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Zip | 60073-1896
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209018014
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041389293
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License Number State | IL
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