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1336211549
CARRIE S FORTMAN
ELGIN, IL
NPI
1336211549
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085001080)
Enumeration Date
2006-11-14
Last Update Date
2020-03-11
Business Address
CARRIE S FORTMAN PAC
1600 N RANDALL RD
ELGIN, IL 60123
Phone number: 847-214-5100
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Mailing Address
CARRIE S FORTMAN PAC
1600 N RANDALL RD
ELGIN, IL 60123-7803
Phone number: 847-214-5100
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