Provider Demographics
NPI:1942542105
Name:ARES, GUILLERMO JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:JAVIER
Last Name:ARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GUILLERMO
Other - Middle Name:JAVIER
Other - Last Name:ARES MAISONET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:833 W 15TH PL UNIT 415
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1845
Mailing Address - Country:US
Mailing Address - Phone:787-415-1944
Mailing Address - Fax:
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL0361396252086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program