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General NPI Number Information
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NPI Number | 1457702953
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Entity Type | Individual
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Provider Name | BRANDYN ASHLEY CASTRO M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/26/2016
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE MC3026
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City | CHICAGO
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State | IL
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Zip | 60637-1447
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Country | US
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Telephone | 773-702-2123
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Fax | 773-702-3518
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Provider Business Mailing Address
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Address Line | 180 HARVESTER DR SUITE 110
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City | BURR RIDGE
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State | IL
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Zip | 60527-7594
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Country | US
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Telephone | 773-702-1150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 036153618
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License Number State | IL
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