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Individual
JOSE J CASTELLANOS
Active
Individual
JOSE J CASTELLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
036073558
IL
207Q00000X
Family Medicine Physician
Primary
036073558
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01616720
BCBS
—
05
—
036073558
—
IL
Enumeration date
07/21/2006
Last updated
07/21/2014
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