Provider Demographics
NPI:1801857149
Name:CANTO, CHRISTOPHER CHARLES (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:CANTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W COURT ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3664
Mailing Address - Country:US
Mailing Address - Phone:888-828-3192
Mailing Address - Fax:509-529-9670
Practice Address - Street 1:1423 CHICAGO RD
Practice Address - Street 2:ST. JAMES HOSPITAL
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-3400
Practice Address - Country:US
Practice Address - Phone:815-937-2239
Practice Address - Fax:815-937-2062
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012322207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2305014000OtherINDEPENDENCE BC
4622394OtherBLUE CROSS
PA1628977OtherHIGHMARK BS
PA1009333440001Medicaid
PA078531Medicare ID - Type Unspecified
CD0278Medicare PIN
4622394OtherBLUE CROSS
PA1628977OtherHIGHMARK BS
K44464Medicare PIN