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NPI Code Detail

MEDICARE: DR. MAURICE A GUZMAN M.D.

MEDICARE: DR. MAURICE A GUZMAN 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
1207Q00000XFamily Medicine Physician036098402IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528057874
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAURICE A GUZMAN M.D.
Provider Business Mailing Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-581-5660
Fax Number : 773-581-5661
Provider Business Practice Location Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-581-5660
Fax Number : 773-581-5661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 11/04/2013

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