Healthcare Provider Details

I. General information

NPI: 1942181482
Provider Name (Legal Business Name): ESTELA GUERRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 10/24/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2248 S MICHIGAN AVE
CHICAGO IL
60616-5258
US

IV. Provider business mailing address

2857 S KILDARE AVE
CHICAGO IL
60623-5195
US

V. Phone/Fax

Practice location:
  • Phone: 312-842-5083
  • Fax: 312-842-5086
Mailing address:
  • Phone: 312-404-0381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number6602-0099-747G
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: