Organization
HISPANIC REGIONAL CLINICS SC
Active
Organization
HISPANIC REGIONAL CLINICS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMON J CASTRO MD (PRESIDENT)
(773) 685-7816
Entity
Organization
Contact information
Practice address
5544 W BELMONT AVE, CHICAGO, IL 60641-4129
(773) 685-7816
(773) 685-4830
Mailing address
5544 W BELMONT AVE, CHICAGO, IL 60641-4129
(773) 685-7816
(773) 685-4830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036083463
IL
207RC0000X
Cardiovascular Disease Physician
036045354
IL
207VG0400X
Gynecology Physician
036039405
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634577
BLUECROSS&BLUESHIELD
IL
05
—
036083463
—
IL
Enumeration date
07/02/2006
Last updated
11/16/2010
Update your record
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