Provider Demographics
NPI:1366480063
Name:CAROL A. CARANI, MD
Entity Type:Organization
Organization Name:CAROL A. CARANI, MD
Other - Org Name:CAROL A. CARANI, MD., LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:ER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-549-8289
Mailing Address - Street 1:29899 RIVER DRIVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1625
Mailing Address - Country:US
Mailing Address - Phone:847-549-8289
Mailing Address - Fax:
Practice Address - Street 1:801 S MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3204
Practice Address - Country:US
Practice Address - Phone:847-990-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-082799282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF16041Medicare UPIN
ILL19163Medicare ID - Type Unspecified