Individual
LISA J GUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4440 W 95TH ST FL 8, OAK LAWN, IL 60453-2600
(708) 684-4200
(708) 520-1885
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-010163
IL
363LF0000X
Family Nurse Practitioner
70000128A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199790
MCARE PART A PROV #
IN
01
—
437901
MCARE GROUP PROV #
IL
01
—
626820
MCARE GROUP PROV #
IN
Enumeration date
09/26/2006
Last updated
04/09/2025
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