Cicero Medical Clinica San Lazaro LLC
NPI 1295822716ActiveOrganization· Family Medicine· Cicero, IL
Family Medicine in Cicero, Illinois, registered in NPPES in October 2006. The authorized official on file is Gerard Licea, MBA, Registered Agent. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1295822716 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 6, 2006 |
| Last updated in NPPES | Jul 16, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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