Individual ProviderCrystal JuarezInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1645 W Jackson Blvd Ste 215, Chicago, IL 60612-3227(312) 942-8028PECOS EnrollmentBased on the most recent information from CMS, provider Crystal Juarez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1689303273Provider TypeIndividualFull NameJuarez, CrystalTitleDr.CredentialMDGenderFemaleSole ProprietorYesEnumeration Date6/8/2022Last Updated6/8/2022Contact InformationPractice LocationPractice Address1645 W Jackson Blvd Ste 215, Chicago, IL 60612-3227Phone(312) 942-8028FaxUnlisted FaxMailing LocationMailing Address1645 W Jackson Blvd Ste 215, Chicago, IL 60612-3227Phone(312) 942-8028FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense125.080502IllinoisCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense125.080502Illinois