Provider Demographics
NPI:1285650002
Name:CASTOR, PATRICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:CASTOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S WELLS ST
Mailing Address - Street 2:UNIT 1205
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4640
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10775 N IL ROUTE 47
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9770
Practice Address - Country:US
Practice Address - Phone:847-669-4771
Practice Address - Fax:847-669-4772
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0270391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice