Individual
DR. GABRIEL SOTOMAYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1802 S MATTIS AVE, CHAMPAIGN, IL 61821-5923
(217) 902-6954
Mailing address
611 W PARK, FAPC, URBANA, IL 61802
(217) 902-6954
(217) 902-7711
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036170227
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2019
Last updated
12/24/2024
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