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Contact Information

LACEY M CARLS, PA-C
1306 GEMINI CIR STE 2
OTTAWA, IL61350
 Phone: 815-433-0850
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LACEY M CARLS · (Female)

NPI # 1114252087
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/12/2009
Last updated 06/23/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085.003635
  • IL License # 085003635
Hospital affiliation(s)
  • ST MARGARETS HOSPITAL - (Acute Care)
    600 E 1ST ST
    SPRING VALLEY, IL 61362
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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