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
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