CICERO MEDICAL CLINICA SAN LAZARO LLC
NPI 1295822716
Family Medicine in Cicero, IL
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, 2028 and lists Gerard Licea, Registered Agent, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cicero Medical Clinica San Lazaro Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Cicero Medical Clinica San Lazaro LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, ILFrequently 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.
Is Cicero Medical Clinica San Lazaro LLC enrolled in Medicare?
Yes. Cicero Medical Clinica San Lazaro LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Cicero Medical Clinica San Lazaro LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Cicero Medical Clinica San Lazaro LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Cicero Medical Clinica San Lazaro LLC accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Cicero Medical Clinica San Lazaro LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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.
# Cicero Medical Clinica San Lazaro Llc · NPI 1295822716
Family Medicine organization in Cicero, Illinois. Organization record, active in the CMS NPPES registry since October 6, 2006.
## Identity
- **NPI:** 1295822716 (Entity type: Organization)
- **Enumerated:** October 6, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Gerard Licea, REGISTERED AGENT
## Practice location
- **Address:** 5712 W 35TH ST, Cicero, IL 60804-4222
- **Phone:** (708) 656-5485 · **Fax:** (708) 656-5657
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 16, 2009
- **Other identifiers:** Medicare PIN 214075 (IL); Other 1636532 (IL); Other DF0534 (IL); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1295822716) · Data from the CMS NPPES public registry.