| Doctor Name: | MRS. CAROL PALMER WARDLAW |
| NPI Number: | 1194942029 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN,APN |
| License Number: | 209002606 |
| Business Practice Address: | 13000 Maple Ave Blue Island, IL - 604062318 |
| Business Phone Number: | 7083856100 |
| Business Fax Number: | 7083852051 |
| Mailing Address: | 13000 Maple Ave, BLUE ISLAND |
| State: | IL |
| Postal Code: | 604062318 |
| Phone Number: | 7083856100 |
| Fax Number: | 7083852051 |
| NPI Enumeration Date: | 04/20/2007 |
| NPI Last Update Date: | 06/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | 209002606 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |