Castillo, Richard
Castillo, Richard is an individual health care provider with primary practice located at 3302 Gerig Dr Suite 100, Bloomington IL 61704-6365. He recently has only one registered license in Allopathic & Osteopathic Physicians / Phlebology, which is considered as his primary health care specialty. Castillo, Richard can be contacted via phone (309) 862-4000.Contact Information
Primary practice address
3302 Gerig Dr Suite 100
Bloomington IL 61704-6365
Phone: (309) 862-4000
Fax: (309) 862-4055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Phlebology | 202K00000X | 036078726 | Illinois |
Profile Details
| NPI number | 1649207960 |
|---|---|
| LBN Legal business name | Castillo, Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Mar 25th, 2014 - about 11 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 | 1649207960 | NPPES |
| Illinois | MEDICAID | 036078726-3 | |
| Illinois | Other | 05721369 |
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