Castaneda, Carlos

Castaneda, Carlos is an individual health care provider with primary practice located at 3249 Oak Park Ave , Berwyn IL 60402-3429. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Castaneda, Carlos can be contacted via phone (708) 795-3159.

Contact Information

Primary practice address
3249 Oak Park Ave Berwyn IL 60402-3429
Phone: (708) 795-3159
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01062180A Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036115939 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X N3541 Texas

Profile Details

NPI number 1053368878
LBN Legal business name Castaneda, Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Nov 11th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053368878 NPPES
Texas Other 1053368878 TRICARE SOUTH
Texas MEDICAID 206743101 TRICARE SOUTH
Texas Other 1053368878 TRICARE SOUTH
Texas Other 01062180A TRICARE SOUTH
Texas MEDICAID 036115939 TRICARE SOUTH
Texas Other 8CD082 TRICARE SOUTH

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