Individual
DR. CARMEN PATRICIA MACIAS HUERTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2740 W FOSTER AVE STE 412, CHICAGO, IL 60625-3532
(773) 293-4362
(847) 763-8937
Mailing address
2740 W FOSTER AVE STE 412, CHICAGO, IL 60625-3532
(773) 293-4362
(847) 763-8937
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036085331
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036085331
IL
207RP1001X
Pulmonary Disease Physician
Primary
036085331
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
036-085331
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215074
BLUE SHIELD PROVIDER NUMB
IL
05
—
036085331
—
IL
Enumeration date
05/02/2006
Last updated
02/25/2024
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