MEDICARE: JULIETA E BARROETA LASTRA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036162463	IL
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	25MA09771600	NJ
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD12189	RI
4	207ZC0500X	Cytopathology Physician	MD424241	PA
5	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD424241	PA

General Provider Information

NPI Number	:	1194890764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIETA E BARROETA LASTRA MD

Provider Business Mailing Address
First Line	:	150 HARVESTER DR STE 300
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-5965
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1443
Country	:	US
Telephone Number	:	773-702-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	04/06/2026

Similar Medicare Providers

1871434597 — POUYAN MOFIDI NASAB MD
Practice Location Address:

5841 S MARYLAND AVE # MC3079
CHICAGO, IL
60637-1443

Practice Phone: 773-834-3531
Practice Fax:

1609717263 — MS. JESSICA KENDALL SIMS MD
Practice Location Address:

5841 S MARYLAND AVE
CHICAGO, IL
60637-1443

Practice Phone: 773-834-3524
Practice Fax:

1447049333 — DR. HANI SAMARAH MD
Practice Location Address:

5841 S MARYLAND AVE , M/C 1035
CHICAGO, IL
60637-1443

Practice Phone: 773-702-1865
Practice Fax: 773-834-3888

1124969712 — ALEXANDRA DIAZ-BARBE
Practice Location Address:

5841 S MARYLAND AVE
CHICAGO, IL
60637-1443

Practice Phone: 773-702-6840
Practice Fax:

1285575894 — TAYTUM FAITH KAHL MD
Practice Location Address:

5841 S MARYLAND AVE
CHICAGO, IL
60637-1443

Practice Phone: 773-702-6118
Practice Fax:

1376005298 — KARYSSA SCHROUDER KNOPOFF MD
Practice Location Address:

5841 S MARYLAND AVE # MC4060
CHICAGO, IL
60637-1443

Practice Phone: 773-702-6808
Practice Fax: 773-702-9881

Directions to “ JULIETA E BARROETA LASTRA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.