MEDICARE: CLINICA GUADALUPE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	036068407	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0001635727	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1336363563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA GUADALUPE PC

Provider Business Mailing Address
First Line	:	3511 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-3910
Country	:	US
Telephone Number	:	773-277-9100
Fax Number	:	773-277-0860

Provider Business Practice Location Address
First Line	:	3511 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-3910
Country	:	US
Telephone Number	:	773-277-9100
Fax Number	:	773-277-0860

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUAN ANTONIO TORRES-GARZA
Credential	:	MD
Telephone Number	:	773-277-9100

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	01/15/2010

Similar Medicare Providers

1760438477 — FERNANDO A AMPUERO MD
Practice Location Address:

3517 W 26TH ST
CHICAGO, IL
60623-3910

Practice Phone: 773-521-6001
Practice Fax: 773-521-1154

1679680235 — LAWNDALE CHRISTIAN HEALTH CENTER
Practice Location Address:

3910 W OGDEN AVE
CHICAGO, IL
60623-2470

Practice Phone: 872-588-3256
Practice Fax: 872-588-3251

1528204088 — MARQUE MEDICOS 26TH STREET, LLC.
Practice Location Address:

3501 W 26TH ST
CHICAGO, IL
60623-3910

Practice Phone: 773-283-3131
Practice Fax: 773-283-3610

1114389400 — APRIL BOWGREN BCBA
Practice Location Address:

3501 W 26TH ST
CHICAGO, IL
60623-3910

Practice Phone: 773-372-2492
Practice Fax:

1992339949 — DR. RAYYA AJEENAH HUNTER PHARMD
Practice Location Address:

3910 W OGDEN AVE
CHICAGO, IL
60623-2470

Practice Phone: 872-588-3250
Practice Fax:

1669066023 — MADELINE M MEISTER
Practice Location Address:

3910 W OGDEN AVE
CHICAGO, IL
60623-2470

Practice Phone: 872-588-3250
Practice Fax:

Directions to “CLINICA GUADALUPE PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.