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1144614454
JESSIE WAYNE CASTRO
CHICAGO, IL
NPI
1144614454
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 125073447)
Enumeration Date
2015-03-25
Last Update Date
2018-11-27
Business Address
JESSIE WAYNE CASTRO
5145 N CALIFORNIA AVE
CHICAGO, IL 60625
Phone number: 773-989-3808
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Mailing Address
JESSIE WAYNE CASTRO
4703 N ALBANY AVE APT 2
CHICAGO, IL 60625-1195
Phone number: 503-956-7638
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