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NPI Code Detail

MEDICARE: VENANCIO DECASTRO M.D.

MEDICARE: VENANCIO DECASTRO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianIL

General Provider Information

NPI Number : 1205832243
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENANCIO DECASTRO M.D.
Provider Business Mailing Address
First Line : 600 W LAKE COOK RD
Second Line : SUITE 110
City : BUFFALO GROVE
State : IL
Zip : 60089-2089
Country : US
Telephone Number : 847-459-6495
Fax Number : 847-459-7929
Provider Business Practice Location Address
First Line : 1430 N ARLINGTON HEIGHTS RD
Second Line : SUITE 206
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-4830
Country : US
Telephone Number : 847-259-8226
Fax Number : 847-392-5260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 01/07/2008

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Directions to “ VENANCIO DECASTRO M.D.” Practice Location

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