Provider Demographics
NPI:1356493878
Name:JUAREZ, SILVIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SILVIA
Middle Name:
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9680 GOLF RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1522
Mailing Address - Country:US
Mailing Address - Phone:847-699-0800
Mailing Address - Fax:847-296-5686
Practice Address - Street 1:6001 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-2018
Practice Address - Country:US
Practice Address - Phone:708-656-5230
Practice Address - Fax:708-656-6610
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036096587Medicaid
200401OtherMEDICARE PTAN
200401OtherMEDICARE PTAN