Provider Demographics
NPI:1467214726
Name:GUZMAN, ANDREA ALEXIS (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ALEXIS
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12255 S 80TH AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1284
Mailing Address - Country:US
Mailing Address - Phone:708-923-4400
Mailing Address - Fax:708-923-4295
Practice Address - Street 1:12255 S 80TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1284
Practice Address - Country:US
Practice Address - Phone:708-923-4400
Practice Address - Fax:708-923-4295
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-03-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant