Healthcare Provider Details

I. General information

NPI: 1013993104
Provider Name (Legal Business Name): CHRISTOPHER C CAUDILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 W. POLK ST DEPT OF EMERGENCY MEDICINE; 7TH FLOOR; PROFESSIONAL BLD
CHICAGO IL
60612
US

IV. Provider business mailing address

1950 W. POLK ST DEPT OF EMERGENCY MEDICINE; 7TH FLOOR; PROFESSIONAL BLD
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 847-204-8650
  • Fax:
Mailing address:
  • Phone: 847-204-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number36098229
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036-098229
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: