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General NPI Number Information
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NPI Number | 1346327954
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Entity Type | Individual
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Provider Name | GARY J. GUZIEC D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 1431 N. WESTERN AVE. SUITE 210
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City | CHICAGO
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State | IL
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Zip | 60622-1775
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Country | US
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Telephone | 773-489-3313
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Fax | 773-489-3441
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Provider Business Mailing Address
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Address Line | 1431 N. WESTERN AVE. SUITE 210
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City | CHICAGO
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State | IL
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Zip | 60622-1775
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Country | US
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Telephone | 773-489-3313
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Fax | 773-489-3441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016003262
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License Number State | IL
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