Individual
DR. ROSVIDA ANNE B. SAN GABRIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
104 W 6TH ST, SUITE 303, STREATOR, IL 61364-2899
(815) 673-2353
(815) 673-2486
Mailing address
104 W 6TH ST, SUITE 303, STREATOR, IL 61364-2899
(815) 673-2353
(815) 673-2486
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036091951
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091951
—
IL
Enumeration date
01/08/2007
Last updated
12/30/2014
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