Individual provider Active NPI

Alain Erich Decastro, MD

  • Psychiatry Physician
  • Skokie, IL
National Provider Identifier
1710080288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Practice address
4711 W Golf Rd
Suite 400
Skokie, IL 60076
Phone
(847) 679-3079
Fax
(847) 679-8340
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X IL Primary

Addresses

Primary practice location

4711 W Golf Rd
Suite 400
Skokie, IL 60076

Mailing address

4711 W Golf Rd
Suite 400
Skokie, IL 60076
Phone (847) 679-3079

Other identifiers 1

IdentifierTypeStateIssuer
21622889OtherILBC BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081010000474 IL Practitioner - Psychiatry 4789752288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rush Medical College of Rush University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7447 W Talcott Ave
Chicago, IL 60631-3745
Phone (847) 679-3079

Hospital & facility affiliations

  • Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Psychiatry SC Psychiatry CurrentSince Jan 1, 2003 Accepting new patients

Locations

7447 W Talcott Ave
Chicago, IL 60631
Phone (773) 631-6082

4711 Golf Rd
Ste 400
Skokie, IL 60076
Phone (847) 679-3040

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710080288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 W GOLF RD",
            "address_2": "SUITE 400",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "847-679-3079",
            "fax_number": "847-679-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 W GOLF RD",
            "address_2": "SUITE 400",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "847-679-3079",
            "fax_number": "847-679-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECASTRO",
        "first_name": "ALAIN",
        "middle_name": "ERICH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "21622889",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.