Provider Demographics
NPI:1013205046
Name:TANTOCO, JAMEE CASTILLO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMEE
Middle Name:CASTILLO
Last Name:TANTOCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMEE
Other - Middle Name:ROMAN
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2050 PFINGSTEN RD STE 320
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1324
Mailing Address - Country:US
Mailing Address - Phone:847-998-4170
Mailing Address - Fax:847-998-4165
Practice Address - Street 1:2050 PFINGSTEN RD STE 320
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026
Practice Address - Country:US
Practice Address - Phone:847-998-4170
Practice Address - Fax:847-998-4165
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125059451207R00000X, 207R00000X
IL036.135196207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine