Individual
CARMELO ANTONIO SARACENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Mailing address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036137891
IL
207YS0123X
Facial Plastic Surgery Physician
ME30412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0394823-00
—
FL
01
—
214881
MEDICARE GROUP PTAN
IL
Enumeration date
03/28/2009
Last updated
01/16/2017
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