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General NPI Number Information
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NPI Number | 1962670299
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Entity Type | Organization
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Legal Business Name | G C GUZMAN MDSC
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 1213 JOLIET ST SUITE E
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City | WEST CHICAGO
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State | IL
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Zip | 60185-3700
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Country | US
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Telephone | 630-231-7632
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 JOLIET ST SUITE E
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City | WEST CHICAGO
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State | IL
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Zip | 60185-3700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GERARDO GUZMAN
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Credential |
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Telephone | 630-231-7632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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