Individual
JOSE J CASTELLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4941 N KEDZIE AVE, CHICAGO, IL 60625-5009
(773) 509-9099
(773) 509-9006
Mailing address
PO BOX 577489, CHICAGO, IL 60657-7335
(872) 226-9199
(773) 509-9006
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
036073558
IL
207Q00000X
Family Medicine Physician
Primary
036073558
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01616720
BCBS
—
05
—
036073558
—
IL
Enumeration date
07/21/2006
Last updated
07/21/2014
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