CICERO MEDICAL CLINICA SAN LAZARO LLC
NPI 1295822716
Family Medicine in Cicero, IL

Q: What is Cicero Medical Clinica San Lazaro LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since October 06, 2006CLIA 14D1018300 · Waiver

5712 W 35TH ST, CICERO, IL 60804(708) 656-5485(708) 656-5657 Get Directions Write a Review

NPPES record last updated: July 16, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Cicero Medical Clinica San Lazaro Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CICERO MEDICAL CLINICA SAN LAZARO LLC (NPI 1295822716) is a healthcare organization registered as a family medicine in Cicero, Illinois and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through September 5, 2026 and lists Gerard Licea, Registered Agent, as its authorized official.

NPPES Registry Identity

NPI1295822716

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameCICERO MEDICAL CLINICA SAN LAZARO LLC

Location Address5712 W 35TH STCicero, IL 60804-4222

Mailing Address5712 W 35th StCicero, IL 60804-4222 · (708) 656-5485 · Fax (708) 656-5657

Phone(708) 656-5485

Fax(708) 656-5657

Organization SubpartNo

Authorized OfficialGerard LiceaRegistered Agent · (708) 656-5485

Enumeration DateOctober 6, 2006

Last NPPES UpdateJuly 16, 2009

✔ NPI 1295822716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5712 W 35TH ST, Cicero, IL 60804

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Other Identifiers 4

Medicare PIN214075IL

Other1636532IL · Blue Cross Blue Shield

OtherDF0534IL · Railroad Medicare

Other0179982IL · Healthspring

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1018300

Cicero Medical Center Clinica San Lazaro · Cicero, IL

Active · expires Sep 5, 2026

CLIA Number14D1018300

Laboratory TypePhysician Office

Certificate Effective DateSeptember 6, 2024

Certificate Expiration DateSeptember 5, 2026

Laboratory DirectorRosaura Licea

Laboratory Phone(708) 656-5485

Laboratory LocationCicero Medical Center Clinica San Lazaro5712 W 35th St, Cicero, IL 60804

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIFFANY HILLIARD

Nurse Practitioner (Family)

5712 W 35TH ST
CICERO, IL 60804

Cook County (708) 656-5485

ROSAURA LICEA MD

Family Medicine

5712 W 35TH ST
CICERO, IL 60804

Cook County (708) 656-5485

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cicero Medical Clinica San Lazaro LLC's NPI number?

The NPI number for Cicero Medical Clinica San Lazaro LLC is 1295822716. It was assigned to this organization in the NPPES registry on October 6, 2006.

Where is Cicero Medical Clinica San Lazaro LLC located?

Cicero Medical Clinica San Lazaro LLC is located at 5712 W 35th St, Cicero, IL 60804. The listed phone number is (708) 656-5485.

What is Cicero Medical Clinica San Lazaro LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Cicero Medical Clinica San Lazaro LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1018300) is associated with this NPI, valid through September 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cicero Medical Clinica San Lazaro LLC was last updated on July 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.