Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Cicero Medical Clinica San Lazaro LLC

Organization Family Medicine Physician · NPI 1295822716

Cicero Medical Clinica San Lazaro LLC provides Family Medicine Physician services in Cicero, Illinois. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5712 W 35th St
Cicero, IL 60804-4222 Not confirmed with CMS for 17 years — call before visiting
Phone: (708) 656-5485
Fax: (708) 656-5657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1295822716
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gerard Licea — Registered Agent · (708) 656-5485
NPI enumeratedOctober 6, 2006
Last updated in NPPESJuly 16, 2009
Mailing address5712 W 35th St, Cicero, IL 60804-4222

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