Provider Demographics
NPI:1134937154
Name:NATERA GARCIA, CARLOS ALBERTO (SA-C)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALBERTO
Last Name:NATERA GARCIA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3065 N CLYBOURN AVE APT 2F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-8007
Mailing Address - Country:US
Mailing Address - Phone:847-477-0308
Mailing Address - Fax:
Practice Address - Street 1:3065 N CLYBOURN AVE APT 2F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-8007
Practice Address - Country:US
Practice Address - Phone:847-477-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL24-579246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant