Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036.135196 | IL |
N | 207R00000X | Internist | 125059451 | IL |
N | 111NI0900X | Internist | 125059451 | IL |
NPI | 1013205046 |
---|---|
Provider Name | Dr. Jamee Castillo Tantoco |
First Address | Glenview, IL 60026-1324 |
Second Address | Glenview, IL 60026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2011 |
Last Update Date | 30/10/2018 |