Isabelo Christopher Castillo, M.D.
Individual provider Active NPI Urology Physician · Macomb, IL
NPI 1124088943 · NPPES record last updated Aug 8, 2013
Key facts
- NPI
- 1124088943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 306089354 (IL)
- Practice address
- 501 E Grant St
Macomb, IL 61455-3375 - Phone
- (309) 837-2100
- Fax
- (309) 387-5800
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306089354 | IL | MD | Urology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 306089354 | IL | Yes |
Addresses
Primary practice location
501 E Grant St
Macomb, IL 61455-3375
Mailing address
501 E. Grant Street
Unit 4
Macomb, IL 61455-3375
Phone (309) 837-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036089354 | Medicaid | IL |
Other providers in Macomb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.