MEDICARE: MR. CHARLES DOUGLAS CAMPBELL JR.

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
1	172A00000X	Driver

General Provider Information

NPI Number	:	1740513431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES DOUGLAS CAMPBELL JR.

Provider Business Mailing Address
First Line	:	4743 N KILBOURN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-4006
Country	:	US
Telephone Number	:	773-283-1742
Fax Number	:	773-283-1742

Provider Business Practice Location Address
First Line	:	2018 217TH ST
Second Line	:
City	:	SAUK VILLAGE
State	:	IL
Zip	:	60411-4521
Country	:	US
Telephone Number	:	773-283-1742
Fax Number	:	773-283-1742

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2009
Last Update Date	:	09/11/2009

Similar Medicare Providers

1871476804 — ERIE FAMILY OPTICAL LLC
Practice Location Address:

2400 VILLAGE VISTA DRIVE
ERIE, CO
80516-4521

Practice Phone: 303-456-9456
Practice Fax: 303-467-0145

1992657167 — MACHAI JALEEL COBBS
Practice Location Address:

21901 OLIVIA AVE
SAUK VILLAGE, IL
60411-4937

Practice Phone: 708-248-2111
Practice Fax:

1902801087 — CONSUMERS PHARMACY INC.
Practice Location Address:

1 SURREYBROOK PLAZA
SAUK VILLAGE, IL
60411

Practice Phone: 708-757-4030
Practice Fax: 708-757-4728

1336123041 — DR MARILYN D JACKSON & ASSOCIATES LTD
Practice Location Address:

1705 E SAUK TRL
SAUK VILLAGE, IL
60411-4955

Practice Phone: 708-757-3100
Practice Fax: 708-757-3272

1700892205 — WALGREEN CO
Practice Location Address:

2601 E SAUK TRL
SAUK VILLAGE, IL
60411-5262

Practice Phone: 708-757-6906
Practice Fax: 708-757-7867

1679642631 — MR. ROBERT LEO NORMAN SR. M.A., LCPC, CADC
Practice Location Address:

826 MARY BYRNE DR
SAUK VILLAGE, IL
60411-5080

Practice Phone: 708-705-2211
Practice Fax:

Directions to “ MR. CHARLES DOUGLAS CAMPBELL JR. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.