Individual
GASTON CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 W HIGGINS RD STE 125, HOFFMAN ESTATES, IL 60169-7203
(847) 884-7111
(847) 884-7156
Mailing address
1860 PAYSHERE CIRCLE, CHICAGO, IL 60674-0001
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-064803
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064803
—
IL
01
—
31603039
BCBS ID
IL
Enumeration date
09/14/2006
Last updated
06/17/2020
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