NPIMap

Organization Active NPI

Castillo-Juat Medical Group SC

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1083886279
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CASTILLO-JUAT MEDICAL GROUP SC
Practice address
3019 N Lincoln Ave
Chicago, IL 60657-4207
Phone
(773) 528-8372
Fax
(773) 528-8372
NPI assigned
Mar 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Annabella Castillo-Juat, MDNPI 1740290022
Title
MD/President
Phone
(773) 528-8372

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X IL Primary

Addresses

Primary practice location

3019 N Lincoln Ave
Chicago, IL 60657-4207

Mailing address

3019 N Lincoln Ave
Chicago, IL 60657-4207
Phone (773) 528-8372

Other identifiers 2

IdentifierTypeStateIssuer
382220OtherILMEDICARE GROUP NUMBER
21604249OtherILBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1083886279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574207",
            "telephone_number": "773-528-8372",
            "fax_number": "773-528-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574207",
            "telephone_number": "773-528-8372",
            "fax_number": "773-528-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTILLO-JUAT MEDICAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "CASTILLO-JUAT",
        "authorized_official_first_name": "ANNABELLA",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "773-528-8372",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "382220",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21604249",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.