Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209017048 | IL |
NPI | 1124521497 |
---|---|
Provider Name | Helen J Castro |
First Address | Chicago, IL 60637-1443 |
Second Address | Waukegan, IL 60087-3123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2018 |
Last Update Date | 16/06/2018 |