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Individual

MR. JAMES ANTHONY CARUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9601 NORTH LINDBERGH DR, # 230, PEORIA, IL 61615
(309) 346-2045
(309) 346-1761
Mailing address
300 HANNA DRIVE, TRAILER 2, PEKIN, IL 61554
(309) 346-2045
(309) 346-1761

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102678
NC

Other

Enumeration date
11/04/2006
Last updated
10/11/2013
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