MEDICARE: CANDICE L CHAMBERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209.020426	IL
2	363LF0000X	Family Nurse Practitioner	277.002944	IL

General Provider Information

NPI Number	:	1093300998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE L CHAMBERS

Provider Business Mailing Address
First Line	:	19710 GOVERNORS HWY STE 8
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-2081
Country	:	US
Telephone Number	:	708-854-1500
Fax Number	:	833-740-4378

Provider Business Practice Location Address
First Line	:	19710 GOVERNORS HWY STE 8
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-2081
Country	:	US
Telephone Number	:	708-854-1500
Fax Number	:	833-740-4378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2021
Last Update Date	:	08/23/2025

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Directions to “ CANDICE L CHAMBERS ” Practice Location

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