Individual provider Active NPI

Rafael Garza Castillon Jr., M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chicago, IL
National Provider Identifier
1720510597
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
036150901 Issued in IL
Practice address
675 N Saint Clair St FL 17
Chicago, IL 60611-5975
Phone
(312) 695-3800
Fax
(312) 695-3644
NPI assigned
Mar 31, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036150901 IL Primary

Addresses

Primary practice location

675 N Saint Clair St FL 17
Chicago, IL 60611-5975

Mailing address

675 N Saint Clair St FL 17
Chicago, IL 60611-5975
Phone (312) 695-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191022002576 IL Practitioner - Thoracic SurgeryPractitioner - Other (Physician) 7315298254 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Oct 6, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Oct 6, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Fl 17
Chicago, IL 60611
Phone (312) 695-3800

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1720510597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-3800",
            "fax_number": "312-695-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-3800",
            "fax_number": "312-695-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA CASTILLON",
        "first_name": "RAFAEL",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036150901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.