Individual
JOSE VENCEDOR GARCIA MALICDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(331) 262-9646
Mailing address
1537 N BOSWORTH AVE APT 2, CHICAGO, IL 60642-2480
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
156237
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209034131
IL
Other
Enumeration date
11/05/2025
Last updated
03/03/2026
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