Individual
DR. JOSE L. GUEVARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1486 MERCHANT DR, ALGONQUIN, IL 60102-5917
(847) 658-6667
(847) 658-6669
Mailing address
1486 MERCHANT DR, ALGONQUIN, IL 60102-5917
(847) 658-6667
(847) 658-6669
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036106727
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005600189
BLUE CROSS BLUE SHIELD
IL
05
—
036106727
—
IL
Enumeration date
10/23/2006
Last updated
01/18/2022
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