MEDICARE: DR. HELEN S GUE 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	207RH0000X	Hematology (Internal Medicine) Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0031602140	OTHER	IL	BLUE CROSS NO

General Provider Information

NPI Number	:	1326151796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELEN S GUE MD

Provider Business Mailing Address
First Line	:	7106 EXNER RD
Second Line	:
City	:	DARIEN
State	:	IL
Zip	:	60561-3503
Country	:	US
Telephone Number	:	630-212-2419
Fax Number	:	630-512-0173

Provider Business Practice Location Address
First Line	:	5053 S DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-4718
Country	:	US
Telephone Number	:	773-436-2170
Fax Number	:	630-512-0173

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/09/2007

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