Healthcare Provider Details

I. General information

NPI: 1013347368
Provider Name (Legal Business Name): MR. FRANCISCO GUEVARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2013
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 S STATE ST
CHICAGO IL
60616-1216
US

IV. Provider business mailing address

1718 S STATE ST
CHICAGO IL
60616-1216
US

V. Phone/Fax

Practice location:
  • Phone: 773-430-0314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: