Individual
GUSTAVO MOSQUERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E PLUMMER BLVD, CHATHAM, IL 62629-8047
(217) 483-3487
(217) 483-8151
Mailing address
101 E PLUMMER BLVD, CHATHAM, IL 62629-8047
(217) 483-3487
(217) 483-8150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036086050
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086050
—
IL
Enumeration date
01/14/2008
Last updated
02/25/2016
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