# DR. ROBERTO PEPE CASTRO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1083600050
- **Gender:** Man
- **Credential:** MD.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 036094399 | IL | — |
| 207R00000X | Internal Medicine Physician | 036094399 | IL | — |
| 207R00000X | Internal Medicine Physician | 39883 | IA | Yes |

## Other

- **Enumeration date:** 09/23/2005
- **Last updated:** 12/13/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01626571 | BLUE CROSS & BLUE SHIELD | IL |
| 05 | — | 036094399 | — | IL |
| 01 | — | 1619414 | BCBS GROUP | IL |
| 05 | — | 3633309286030501 | — | IL |