Individual
MR. JUAN MANUEL GARCIA VACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
820 S WOOD STREET, CHICAGO, IL 60612
(312) 996-2933
Mailing address
820 S WOOD STREET, CHICAGO, IL 60612
(312) 996-2933
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125084047
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2024
Last updated
09/27/2024
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