MEDICARE: JOAQUIN J ESTRADA MD

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	208600000X	Surgery Physician	A91251	CA
2	208600000X	Surgery Physician	036.125251	IL

General Provider Information

NPI Number	:	1629126651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAQUIN J ESTRADA MD

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 W NELSON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-6704
Country	:	US
Telephone Number	:	773-296-7095
Fax Number	:	773-296-9420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2025

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