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NPI Code Detail

MEDICARE: EDGAR DELCASTILLO M.D.

MEDICARE: EDGAR DELCASTILLO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician036047844IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295799302
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR DELCASTILLO M.D.
Provider Business Mailing Address
First Line : 560 ABERDEEN RD
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-9715
Country : US
Telephone Number : 708-709-6396
Fax Number : 708-709-6353
Provider Business Practice Location Address
First Line : 2875 W 19TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3501
Country : US
Telephone Number : 773-484-4040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 12/14/2016

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