Provider Demographics
NPI:1093013716
Name:JAMES CARUSO MEDICAL INC
Entity Type:Organization
Organization Name:JAMES CARUSO MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CARUSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-736-8500
Mailing Address - Street 1:572 S BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-1362
Mailing Address - Country:US
Mailing Address - Phone:630-736-8500
Mailing Address - Fax:773-282-4728
Practice Address - Street 1:572 S BARTLETT RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-1362
Practice Address - Country:US
Practice Address - Phone:630-736-8500
Practice Address - Fax:773-282-4728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36082576208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty