Provider Demographics
NPI:1497870315
Name:SITJAR, GUADALUPE S (MD)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:S
Last Name:SITJAR
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 1:135 NORTH GREENLEAF
Mailing Address - Street 2:SUITE #224
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3371
Mailing Address - Country:US
Mailing Address - Phone:847-336-9159
Mailing Address - Fax:847-336-9159
Practice Address - Street 1:135 NORTH GREENLEAF
Practice Address - Street 2:SUITE #224
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3371
Practice Address - Country:US
Practice Address - Phone:847-336-9159
Practice Address - Fax:847-336-9159
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C38280Medicare UPIN
IL246180Medicare ID - Type Unspecified