MEDICARE: CLIFFORD CASTILLO RPH

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
1	183500000X	Pharmacist	051304104	IL
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	051304104	IL

General Provider Information

NPI Number	:	1508534983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFFORD CASTILLO RPH

Provider Business Mailing Address
First Line	:	2559 W 95TH ST
Second Line	:
City	:	EVERGREEN PARK
State	:	IL
Zip	:	60805-2809
Country	:	US
Telephone Number	:	708-422-2056
Fax Number	:	773-422-2302

Provider Business Practice Location Address
First Line	:	2559 W 95TH ST
Second Line	:
City	:	EVERGREEN PARK
State	:	IL
Zip	:	60805-2809
Country	:	US
Telephone Number	:	708-422-2056
Fax Number	:	708-422-2032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2021
Last Update Date	:	05/20/2026

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Directions to “ CLIFFORD CASTILLO RPH” Practice Location

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