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1114543055
MICHAEL CASTANEDA
PARK RIDGE, IL
NPI
1114543055
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209021107)
Enumeration Date
2020-06-16
Last Update Date
2020-06-16
Business Address
MICHAEL CASTANEDA
1875 DEMPSTER ST STE 110
PARK RIDGE, IL 60068-1125
Phone number: 847-897-9010
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Mailing Address
MICHAEL CASTANEDA
8540 W ROSEVIEW DR
NILES, IL 60714-1856
Phone number: 847-910-6059
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