Provider Demographics
NPI:1144320037
Name:CARAG, HENRY (MD)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:CARAG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 W CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-3402
Mailing Address - Country:US
Mailing Address - Phone:773-762-8400
Mailing Address - Fax:773-762-8401
Practice Address - Street 1:2915 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3402
Practice Address - Country:US
Practice Address - Phone:773-762-8400
Practice Address - Fax:773-762-8401
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3646089207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2070922001OtherCIGNA
IL216235Medicare PIN
2070922001OtherCIGNA