MEDICARE: GARCIA LIFE PARTNERS LTD

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1632097	OTHER	IL	BLUE SHIELD

General Provider Information

NPI Number	:	1770500621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARCIA LIFE PARTNERS LTD

Provider Business Mailing Address
First Line	:	7937 S HARLEM AVE STE 278
Second Line	:
City	:	BURBANK
State	:	IL
Zip	:	60459-1600
Country	:	US
Telephone Number	:	773-884-4523
Fax Number	:	773-884-4580

Provider Business Practice Location Address
First Line	:	5101 S KILDARE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-4608
Country	:	US
Telephone Number	:	773-735-5600
Fax Number	:	773-735-9489

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BERNADINO GARCIA
Credential	:	M.D.
Telephone Number	:	773-735-5600

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	04/18/2023

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