MEDICARE: JOHN PAUL CUEVA M.D.

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	208000000X	Pediatrics Physician	036085818	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01620924	OTHER	IL	BLUE SHIELD NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457346355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN PAUL CUEVA M.D.

Provider Business Mailing Address
First Line	:	10448 S PULASKI RD STE 1
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-4895
Country	:	US
Telephone Number	:	708-346-7000
Fax Number	:	708-346-6180

Provider Business Practice Location Address
First Line	:	10448 S PULASKI RD STE 1
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-4895
Country	:	US
Telephone Number	:	708-346-7000
Fax Number	:	708-346-6180

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	01/06/2023

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