Provider Demographics
NPI:1134937154
Name:NATERA GARCIA, CARLOS ALBERTO (SA-C)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALBERTO
Last Name:NATERA GARCIA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3065 N CLYBOURN AVE APT 2F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-8007
Mailing Address - Country:US
Mailing Address - Phone:847-477-0308
Mailing Address - Fax:
Practice Address - Street 1:18761 CHESTNUT CT
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-9501
Practice Address - Country:US
Practice Address - Phone:847-477-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000853363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical