Organization
CHICAGO GASTROENTEROLOGY, LLC
Active
Organization
CHICAGO GASTROENTEROLOGY, LLC
Active
Other names
Chicago GI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL FRANCISCO CASTILLO M.D. (MEMBER)
(847) 708-7496
Entity
Organization
Contact information
Practice address
1431 N WESTERN AVE, SUITE 133, CHICAGO, IL 60622-1797
(773) 342-6800
(773) 342-6332
Mailing address
1431 N WESTERN AVE, SUITE 133, CHICAGO, IL 60622-1797
(773) 342-6800
(773) 342-6332
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
248000667
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036063975
—
IL
05
—
036122662
—
IL
01
—
1205801313
NPI
IL
01
—
1467503672
NPI
IL
01
—
692861
MEDICARE
IL
01
—
I17297
MEDICARE
IL
Enumeration date
09/17/2012
Last updated
09/17/2012
Update your record
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