Healthcare Provider Details

I. General information

NPI: 1477852028
Provider Name (Legal Business Name): MARGRET DE JESUS DE GUZMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RED BUD ILLINOIS HOSPITAL COMANY LLC 325 SPRING ST
RED BUD IL
62278
US

IV. Provider business mailing address

325 SPRING ST
RED BUD IL
62278-1105
US

V. Phone/Fax

Practice location:
  • Phone: 618-282-7373
  • Fax: 618-282-7376
Mailing address:
  • Phone: 618-282-7373
  • Fax: 618-282-7376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2018-02941
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036.148607
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: