Provider Demographics
NPI:1710916663
Name:CASTRO, RAMON J (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:J
Last Name:CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5544 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-4129
Mailing Address - Country:US
Mailing Address - Phone:773-685-7816
Mailing Address - Fax:773-685-4830
Practice Address - Street 1:5544 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-4129
Practice Address - Country:US
Practice Address - Phone:773-685-7816
Practice Address - Fax:773-685-4830
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083463207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK07734Medicare PIN
ILF08229Medicare UPIN