Individual
ERICA ANNETTE GUZALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 S FAIRFIELD AVE, CHICAGO, IL 60608-1782
(773) 542-2000
Mailing address
111 E CHESTNUT ST, CHICAGO, IL 60611-2051
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
G86522
CA
2085R0202X
Diagnostic Radiology Physician
Primary
036141487
IL
2085R0202X
Diagnostic Radiology Physician
G86522
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G865220
BLUE SHIELD OF CA
—
05
—
00G865220
—
CA
05
—
036141487
—
IL
01
—
300133826
RAILROAD MEDICARE
—
Enumeration date
07/18/2005
Last updated
10/02/2025
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