Caceres, Luis J
Caceres, Luis J is an individual health care provider with primary practice located at 1770 E Lake Shore Dr Ste 105 , Decatur IL 62521-3800. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Caceres, Luis J can be contacted via phone (217) 422-6100.Contact Information
Primary practice address
1770 E Lake Shore Dr Ste 105
Decatur IL 62521-3800
Phone: (217) 422-6100
Fax: (833) 784-5326
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036-084129 | Illinois |
| Other Service Providers / Specialist | 174400000X | 036-084129 | Illinois |
Profile Details
| NPI number | 1942381496 |
|---|---|
| LBN Legal business name | Caceres, Luis J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Dec 20th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942381496 | NPPES |
| Illinois | Other | 060045170 | RAILROAD |
| Illinois | MEDICAID | 036084129 | RAILROAD |
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