Healthcare Provider Details
I. General information
NPI: 1023105301
Provider Name (Legal Business Name): MARGARITA GUARIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/06/2006
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date: 11/15/2024
Reactivation Date: 11/21/2024
III. Provider practice location address
5841 S MARYLAND AVE
CHICAGO IL
60637-1443
US
IV. Provider business mailing address
150 HARVESTER DR STE 300
BURR RIDGE IL
60527-5965
US
V. Phone/Fax
- Phone: 773-702-6178
- Fax:
- Phone: 773-702-1150
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036.150815 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0214X |
| Taxonomy | Pediatric Pulmonology Physician |
| License Number | 036.150815 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: