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Individual

DR. JINGTAO J GUO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2252 S CANAL ST STE 201, CHICAGO, IL 60616-1838
(312) 225-5829
Mailing address
2252 S CANAL ST STE 201, CHICAGO, IL 60616-1838
(312) 225-5829

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-107010
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-107010-2
IL
Enumeration date
08/30/2005
Last updated
05/27/2022
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