Healthcare Provider Details

I. General information

NPI: 1578475539
Provider Name (Legal Business Name): LEAH CASTILLO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 EAGLE ST
JOLIET IL
60432-2031
US

IV. Provider business mailing address

1201 EAGLE ST
JOLIET IL
60432-2031
US

V. Phone/Fax

Practice location:
  • Phone: 815-740-8100
  • Fax: 708-202-5444
Mailing address:
  • Phone: 815-740-8100
  • Fax: 708-202-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number041.409621
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: