MEDICARE: NOEL CASTELINO SC

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	225400000X	Rehabilitation Practitioner	036099795	IL

Other Identifiers

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

General Provider Information

NPI Number	:	1841411741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOEL CASTELINO SC

Provider Business Mailing Address
First Line	:	50 E SCHILLER ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-2110
Country	:	US
Telephone Number	:	847-673-4800
Fax Number	:	847-673-9322

Provider Business Practice Location Address
First Line	:	6352 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1213
Country	:	US
Telephone Number	:	872-208-3095
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	AJITH R CASTELINO
Credential	:
Telephone Number	:	847-673-4800

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/20/2021

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Directions to “NOEL CASTELINO SC ” Practice Location

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