Healthcare Provider Details

I. General information

NPI: 1114085313
Provider Name (Legal Business Name): FLORDELIZA GERALDEZ VILLAFUERTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 N MOZART SUITE 205
CHICAGO IL
60622
US

IV. Provider business mailing address

1044 N MOZART SUITE 205
CHICAGO IL
60622
US

V. Phone/Fax

Practice location:
  • Phone: 773-489-2913
  • Fax:
Mailing address:
  • Phone: 773-489-2913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number3648152
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: