Clinica Guadalupe Pc

LBN: Clinica Guadalupe Pc
Clinica Guadalupe Pc is an health care organization with primary practice located at 3511 W 26Th St , Chicago IL 60623-3910. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. Clinica Guadalupe Pc can be contacted via phone (773) 277-9100, or through Torres-Garza, Juan Antonio via phone (773) 277-9100.

Contact Information

Primary practice address
3511 W 26Th St Chicago IL 60623-3910
Phone: (773) 277-9100
Fax: (773) 277-0860
Website:
Map and Directions
Authorized official contact:
Name: Torres-Garza, Juan Antonio Doctor of Medicine (MD)
Phone: (773) 277-9100

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 036068407 Illinois

Profile Details

NPI number 1336363563
LBN Legal business name Clinica Guadalupe Pc
DBA Doing business as
Authorized official Torres-Garza, Juan Antonio Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2007
Last updated Jan 15th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336363563 NPPES
Illinois MEDICAID 036068407
Illinois Other 0001635727

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