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Individual

J ERIC D CASTRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1105 W PARK AVE STE 7, LIBERTYVILLE, IL 60048-2567
(847) 773-0369
(847) 201-2573
Mailing address
2260 CHURCHILL CIR, LIBERTYVILLE, IL 60048-4298
(773) 771-4160

Taxonomy

Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
036103419
IL
207NS0135X
Procedural Dermatology Physician
71511
AZ
207P00000X
Emergency Medicine Physician
Primary
036103419
IL
207P00000X
Emergency Medicine Physician
53459-20
WI
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
036103419
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036103419
IL
01
1316971807
BLUE CROSS BLUE SHIELD
WI
05
1316971807
WI
01
P00264268
RAILROAD MEDICARE
IL
Enumeration date
07/10/2006
Last updated
10/20/2023
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