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Physician Compare National (NPI:1740455021)

HEALTHCARE PROVIDER: MIREL L. CASTLE PSY.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1740455021
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2860790193
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20160419002612
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name CASTLE
Individual professional last name
Provider First Name MIREL
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2010
Individual professional's medical school graduation year
Primary Specialty PSYCHOLOGIST, CLINICAL
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 1818 DEMPSTER ST
Group Practice or individual's line 1 address
City EVANSTON
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 602021003
Group Practice or individual's zip code (9 digits when available)
Phone Number 7738314090
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment M

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