Provider Demographics
NPI:1194144428
Name:GUERRA, RAUL
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:
Last Name:GUERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2007
Mailing Address - Country:US
Mailing Address - Phone:847-759-0389
Mailing Address - Fax:847-789-8579
Practice Address - Street 1:463 CAMBRIDGE RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2007
Practice Address - Country:US
Practice Address - Phone:847-759-0389
Practice Address - Fax:847-789-8579
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter