CLINICA GUADALUPE PC NPI 1336363563

NPI Information

NPI: 1336363563
Provider Name: CLINICA GUADALUPE PC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
3511 W 26TH ST
CHICAGO, IL
ZIP 60623
Phone: (773) 277-9100
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CLINICA GUADALUPE PC is a general practice in Chicago, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CLINICA GUADALUPE PC NPI is 1336363563. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3511 W 26TH ST
CHICAGO, IL
ZIP 60623-910
Phone: (773) 277-9100
Fax: (773) 277-0860

The provider's authorized official is Juan Antonio Torres-garza .
The authorized official title is President and has the following contact phone number (773) 277-9100.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 1/15/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		036068407	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	946990	MEDICARE PIN	ILLINOIS
2	036068407	MEDICAID	ILLINOIS
3	0001635727	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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