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Individual

DR. CHARISA M SPOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
4440 W 95TH, RADIOLOGY DEPARTMENT, OAK LAWN, IL 60453
(708) 684-8000
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036078515
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036078515
IL
01
1618334
BCBS ID
IL
01
P00110671
RAILROAD
IL
Enumeration date
09/13/2006
Last updated
03/05/2026
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