Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cicero Medical Clinica San Lazaro LLC

Organization Family Medicine Physician · NPI 1295822716

Cicero Medical Clinica San Lazaro LLC is a Family Medicine Physician 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
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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