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NPI Code Detail

MEDICARE: DR. NICHOLAS CHARLES CARO M.D.

MEDICARE: DR. NICHOLAS CHARLES CARO 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
1207W00000XOphthalmology Physician036-061321IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11617766OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1730236589
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS CHARLES CARO M.D.
Provider Business Mailing Address
First Line : 4151 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number : 773-685-5606
Fax Number : 773-685-6559
Provider Business Practice Location Address
First Line : 4151 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number : 773-685-5606
Fax Number : 773-685-6559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 02/21/2013

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