Provider Demographics
NPI:1093300998
Name:CHAMBERS, CANDICE L
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:L
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19710 GOVERNORS HWY STE 8
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-2081
Mailing Address - Country:US
Mailing Address - Phone:708-854-1500
Mailing Address - Fax:833-740-4378
Practice Address - Street 1:19710 GOVERNORS HWY STE 8
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2081
Practice Address - Country:US
Practice Address - Phone:708-854-1500
Practice Address - Fax:833-740-4378
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.020426363LF0000X
IL277.002944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily