Organization
CASTILLO-JUAT MEDICAL GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNABELLA CASTILLO-JUAT MD (MD/PRESIDENT)
(773) 528-8372
Entity
Organization
Contact information
Practice address
3019 N LINCOLN AVE, CHICAGO, IL 60657-4207
(773) 528-8372
(773) 528-8372
Mailing address
3019 N LINCOLN AVE, CHICAGO, IL 60657-4207
(773) 528-8372
(773) 528-8372
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21604249
BCBS
IL
01
—
382220
MEDICARE GROUP NUMBER
IL
Enumeration date
03/27/2008
Last updated
04/16/2008
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