Provider Demographics
NPI:1487628228
Name:TURK, CHARLES OLIVER (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:OLIVER
Last Name:TURK
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 1:10400 SOUTHWEST HWY
Mailing Address - Street 2:LL
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-1367
Mailing Address - Country:US
Mailing Address - Phone:708-888-8287
Mailing Address - Fax:708-428-4277
Practice Address - Street 1:10400 SOUTHWEST HWY
Practice Address - Street 2:LL
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-1367
Practice Address - Country:US
Practice Address - Phone:708-888-8287
Practice Address - Fax:708-428-4277
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036064703208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036064703Medicaid
IL3265OtherGROUP PTAN
IL036064703Medicaid
211475Medicare PIN
IL3265001Medicare PIN
C49098Medicare UPIN