Healthcare Provider Details

I. General information

NPI: 1669506390
Provider Name (Legal Business Name): CHARMAINE M CARDOZO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16505 106TH CT
ORLAND PARK IL
60467-4522
US

IV. Provider business mailing address

16505 106TH CT
ORLAND PARK IL
60467-4522
US

V. Phone/Fax

Practice location:
  • Phone: 708-364-1550
  • Fax: 708-364-1468
Mailing address:
  • Phone: 708-364-1550
  • Fax: 708-364-1468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number036-115658
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: