Provider Demographics
NPI:1558251777
Name:CARR, CHAZZ N (CLC, CFSD)
Entity type:Individual
Prefix:MRS
First Name:CHAZZ
Middle Name:N
Last Name:CARR
Suffix:
Gender:F
Credentials:CLC, CFSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 WESTINGHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62221-3494
Mailing Address - Country:US
Mailing Address - Phone:618-971-0327
Mailing Address - Fax:
Practice Address - Street 1:2629 WESTINGHOUSE DR
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62221-3494
Practice Address - Country:US
Practice Address - Phone:618-971-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty