| Centro Castillo For Personal And Family Wellbeing, Llc | |
|
6250 W North Ave Fl 1 Chicago IL 60639-3861 | |
| (773) 622-6218 | |
| (773) 622-7440 |
| Full Name | Centro Castillo For Personal And Family Wellbeing, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6250 W North Ave Fl 1, Chicago, Illinois |
| Authorized Official Name and Position | Paula Carolina Castillo (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3129091007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Castillo For Personal And Family Wellbeing, Llc 6250 W North Ave Fl 1 Chicago IL 60639-3861 Ph: (773) 622-6218 | Centro Castillo For Personal And Family Wellbeing, Llc 6250 W North Ave Fl 1 Chicago IL 60639-3861 Ph: (773) 622-6218 |
| NPI Number | 1598942484 |
|---|---|
| Provider Enumeration Date | 01/23/2008 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 8022196641 |
|---|---|
| Medicare Enrollment ID | O20080423000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598942484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180-005107 (Illinois) | Secondary |
| 103TC0700X | Psychologist - Clinical | 071-006546 (Illinois) | Primary |
| Provider Name | Paula C Castillo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992804876 PECOS PAC ID: 7416982574 Enrollment ID: I20050928000524 |
| Provider Name | Joan G De Petrizzi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568544468 PECOS PAC ID: 5092979880 Enrollment ID: I20120606000655 |
| Provider Name | Jonathan Saavedra |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982006219 PECOS PAC ID: 5698194389 Enrollment ID: I20200930000110 |
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