Provider Demographics
NPI:1033249677
Name:GARRETSON, CARA BETH (MD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:BETH
Last Name:GARRETSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N. LAKE SHORE DRIVE
Mailing Address - Street 2:SUITE 818
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60202
Mailing Address - Country:US
Mailing Address - Phone:312-926-3642
Mailing Address - Fax:913-588-8300
Practice Address - Street 1:1460 N. HALSTED ST.
Practice Address - Street 2:# 203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642
Practice Address - Country:US
Practice Address - Phone:312-926-3627
Practice Address - Fax:913-588-8300
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6618207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology