Healthcare Provider Details
I. General information
NPI: 1366016743
Provider Name (Legal Business Name): SARA ADELINA CUADRA ARUGUETE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/19/2021
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5841 S MARYLAND AVE # MC5100
CHICAGO IL
60637-1443
US
IV. Provider business mailing address
180 HARVESTER DR STE 110
BURR RIDGE IL
60527-6686
US
V. Phone/Fax
- Phone: 773-702-3630
- Fax: 773-753-8301
- Phone: 773-702-1150
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | 036175587 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 76870 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: