Individual
MARIA CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
(708) 326-1550
Mailing address
3841 N SPAULDING AVE, CHICAGO, IL 60618-4423
(773) 583-0622
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
057.000890
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057.000890
NA
IL
05
—
057.000890
—
IL
Enumeration date
05/20/2015
Last updated
05/20/2015
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