Provider Demographics
NPI:1821090622
Name:CARRE, JOSEPH NEMOURS (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:NEMOURS
Last Name:CARRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 N CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5208
Mailing Address - Country:US
Mailing Address - Phone:773-262-5400
Mailing Address - Fax:773-743-0136
Practice Address - Street 1:6415 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5208
Practice Address - Country:US
Practice Address - Phone:773-262-5400
Practice Address - Fax:773-743-0136
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-0652532085R0202X, 2085R0204X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL630001349OtherRR MEDICARE
IL01621175OtherBC/BS
IL036065253Medicaid
IL036065253Medicaid
IL01621175OtherBC/BS