Provider Demographics
NPI:1831790674
Name:GUZMAN, CRISTOPHER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CRISTOPHER
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7122 40TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:STICKNEY
Mailing Address - State:IL
Mailing Address - Zip Code:60402-5491
Mailing Address - Country:US
Mailing Address - Phone:708-484-8410
Mailing Address - Fax:
Practice Address - Street 1:7122 40TH ST STE 1
Practice Address - Street 2:
Practice Address - City:STICKNEY
Practice Address - State:IL
Practice Address - Zip Code:60402-5491
Practice Address - Country:US
Practice Address - Phone:708-484-8410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist