Individual
JOSE RAFAEL BALSA GUERRERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-6000
Mailing address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125073408
IL
Other
Enumeration date
08/25/2018
Last updated
08/25/2018
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