Provider Demographics
NPI:1508056664
Name:JASON A CASTATOR MD
Entity Type:Organization
Organization Name:JASON A CASTATOR MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTATOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-595-9988
Mailing Address - Street 1:17 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-2129
Mailing Address - Country:US
Mailing Address - Phone:630-595-9988
Mailing Address - Fax:
Practice Address - Street 1:17 S CENTER ST
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-2129
Practice Address - Country:US
Practice Address - Phone:630-595-9988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care