MEDICARE: KUANGHUA GUO MD, PHD

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	207R00000X	Internal Medicine Physician	125.078910	IL
2	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	036171049	IL

General Provider Information

NPI Number	:	1972996536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KUANGHUA GUO MD, PHD

Provider Business Mailing Address
First Line	:	3916 N FREMONT ST APT 3S
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-7370
Country	:	US
Telephone Number	:	917-773-9943
Fax Number	:

Provider Business Practice Location Address
First Line	:	3324 N CLIFTON AVE APT 2F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-2285
Country	:	US
Telephone Number	:	917-773-9943
Fax Number	:

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

Provider Enumeration Date	:	03/06/2015
Last Update Date	:	05/22/2026

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