Provider Demographics
NPI:1538787460
Name:CASTELAR ARTIGA, JORGE LUIS
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:LUIS
Last Name:CASTELAR ARTIGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:LUIS
Other - Last Name:CASTELAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6326 CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2304
Mailing Address - Country:US
Mailing Address - Phone:708-303-9234
Mailing Address - Fax:773-729-2074
Practice Address - Street 1:6326 CERMAK RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2304
Practice Address - Country:US
Practice Address - Phone:708-303-9234
Practice Address - Fax:773-729-2074
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036165084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine