Individual provider Active NPI

Maurice A Guzman, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1528057874
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036098402 Issued in IL
Practice address
4200 W 63Rd St
Chicago, IL 60629-5010
Phone
(773) 581-5660
Fax
(773) 581-5661
NPI assigned
Oct 19, 2005
Last updated
Nov 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036098402 IL Primary

Addresses

Primary practice location

4200 W 63Rd St
Chicago, IL 60629-5010

Mailing address

4200 W 63Rd St
Chicago, IL 60629-5010
Phone (773) 581-5660

Other identifiers 1

IdentifierTypeStateIssuer
036098402MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110922000709 IL Practitioner - Family PracticePractitioner - Pediatric Medicine 9739350703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Galilee Medical Center SCGroup PAC ID 5395648836, 3 clinicians

Practice addresses (Care Compare)

1554 Todd Farm Dr
Elgin, IL 60123-1287
Phone (847) 888-7423

4200 W 63Rd St
Chicago, IL 60629-5010
Phone (773) 581-5660

4941 N Kedzie Ave
Chicago, IL 60625-5009
Phone (773) 509-9099

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Galilee Medical Center, S.C. CurrentSince May 1, 2014 Accepting new patients
Galilee Medical Center, S.C. Family Medicine CurrentSince May 1, 2014 Accepting new patients

Locations

4200 W 63rd St
Chicago, IL 60629
Phone (773) 581-5600

4849 W Fullerton Ave
Chicago, IL 60639
Phone (773) 237-2900

4941 N Kedzie Ave
Chicago, IL 60625
Phone (773) 293-0451

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1528057874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295010",
            "telephone_number": "773-581-5660",
            "fax_number": "773-581-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295010",
            "telephone_number": "773-581-5660",
            "fax_number": "773-581-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "MAURICE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036098402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098402",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.