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Organization

CARITAS PHYSICIANS GROUP

Active
Parent organization
CARITAS, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
CARITAS, INC
Authorized official
JESSECA WATSON (CONTRACTS AND CREDENTIALING MANAGER)
(630) 572-8228
Entity
Organization

Contact information

Practice address
140 NORTH ASHLAND AVENUE, CHICAGO, IL 60607
(312) 850-9411
(312) 850-3288
Mailing address
1301 WEST 22ND STREET, SUITE 500, OAK BROOK, IL 60523
(630) 572-8228
(630) 572-0566

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QA0401X
Addiction Medicine (Family Medicine) Physician
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0023
IL
Enumeration date
12/16/2018
Last updated
10/08/2020
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