Corazon B Custodio, MD - Family Medicine in Chicago, IL

Corazon B Custodio, MD is a Family Medicine physician based in Chicago, Illinois. Corazon B Custodio is licensed to practice in Illinois (license number ) and her current practice location is 333 S. State Street, Revenue # 200 Chicago Deptartment Of Public Health, Chicago, Illinois. She can be reached at her office (for appointments etc.) via phone at (312) 747-9443.

NPI number for Corazon B Custodio is 1003911728 and her current mailing address is 333 S. State Street, Revenue # 200 Chicago Deptartment Of Public Health, Chicago, Illinois. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003911728.

Contact Information

Corazon B Custodio, MD
333 S. State Street, Revenue # 200 Chicago Deptartment Of Public Health,
Chicago, IL 60604
(312) 747-9443
(312) 747-9447



Physician's Profile

Full NameCorazon B Custodio
GenderFemale
SpecialityFamily Medicine
Location333 S. State Street, Chicago, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1003911728
  • Provider Enumeration Date: 09/14/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Corazon B Custodio such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003911728NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Corazon B Custodio is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Corazon B Custodio, MD
333 S. State Street, Revenue # 200 Chicago Deptartment Of Public Health,
Chicago, IL 60604

Ph: (312) 747-9443
Corazon B Custodio, MD
333 S. State Street, Revenue # 200 Chicago Deptartment Of Public Health,
Chicago, IL 60604

Ph: (312) 747-9443

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