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NPI Code Detail

MEDICARE: AUGUSTO GUEVARA

MEDICARE: AUGUSTO GUEVARA
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
1207R00000XInternal Medicine Physician36-091726IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
136-091726OTHERILLIC PHYSICIAN

General Provider Information

NPI Number : 1962557686
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUGUSTO GUEVARA
Provider Business Mailing Address
First Line : PO BOX 746715
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6715
Country : US
Telephone Number : 773-253-3933
Fax Number : 773-437-6780
Provider Business Practice Location Address
First Line : 18 CHICAGO AVE
Second Line :
City : OAK PARK
State : IL
Zip : 60302-2402
Country : US
Telephone Number : 773-253-3933
Fax Number : 773-437-6780
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 09/17/2025

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Directions to “ AUGUSTO GUEVARA ” Practice Location

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