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1053058883
EMERITA GUADALUPE PORTILLO GARCIA
CHICAGO, IL
NPI
1053058883
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL 125.079849)
Enumeration Date
2022-05-13
Last Update Date
2022-05-13
Business Address
EMERITA GUADALUPE PORTILLO GARCIA MD
1431 N WESTERN AVE STE 406
CHICAGO, IL 60622-1774
Phone number: 312-633-5841
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Mailing Address
EMERITA GUADALUPE PORTILLO GARCIA MD
4 SENTA CT
BALTIMORE, MD 21207-3959
Phone number: 443-926-7880
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