Basic Information
Provider Information
NPI: 1053569046
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASTIGLIONI
FirstName: CYNTHIA
MiddleName: EMA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 225 E CHICAGO AVE # 152
Address2:  
City: CHICAGO
State: IL
PostalCode: 606112991
CountryCode: US
TelephoneNumber: 3122274000
FaxNumber:  
Practice Location
Address1: 225 E CHICAGO AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606112991
CountryCode: US
TelephoneNumber: 3122274000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/03/2008
LastUpdateDate: 04/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X125-051095ILN Allopathic & Osteopathic PhysiciansPediatrics 
208000000X036-121928ILY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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