# CARLTON A. WEST, MD SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407129364
- **Authorized official:** DR. CARLTON A WEST MD (PRESIDENT)
- **Authorized official phone:** (312) 225-2055

## Contact information

- **Practice address:** 443 E 31ST ST, CHICAGO, IL 60616-4051
- **Practice address phone:** (312) 225-2055
- **Practice address fax:** (312) 225-7437
- **Mailing address:** 443 E 31ST ST, CHICAGO, IL 60616-4051
- **Mailing address phone:** (312) 225-2055
- **Mailing address fax:** (312) 225-7437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/22/2012
- **Last updated:** 02/22/2012