Individual
JOSE L HUERTA SUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1431 N WESTERN AVE STE 503, CHICAGO, IL 60622-1776
(773) 772-9121
Mailing address
201 WAVERLY PL, WAUKESHA, WI 53186-5908
(262) 896-1029
(262) 896-1029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.128879
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036128879
—
IL
Enumeration date
08/26/2009
Last updated
03/18/2021
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