Provider Demographics
NPI:1457562944
Name:GARITI, JAMES C (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:GARITI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2001 BUTTERFIELD RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1050
Mailing Address - Country:US
Mailing Address - Phone:630-725-2832
Mailing Address - Fax:877-489-5993
Practice Address - Street 1:245 S EXECUTIVE DR
Practice Address - Street 2:SUITE 350
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4204
Practice Address - Country:US
Practice Address - Phone:262-373-1647
Practice Address - Fax:262-373-1650
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2016-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI46635020208D00000X
WI46635-0202083X0100X, 202K00000X
IL036121623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL789510OtherGROUP MEDICARE PTAN
WI000068227OtherGROUP MEDICARE PTAN
WIP01658759OtherMECICARE RAILROAD INDIVIDUAL PTAN
IL789511OtherGROUP MEDICARE PTAN
WIDE2420OtherMEDICARE RAILROAD GROUP PTAN
IL789511OtherGROUP MEDICARE PTAN
IL789510OtherGROUP MEDICARE PTAN
WIP01658759OtherMECICARE RAILROAD INDIVIDUAL PTAN
ILF400104686Medicare PIN