Individual
DR. HENRY GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2008 N PULASKI RD, CHICAGO, IL 60639-3767
(773) 968-6942
Mailing address
10225A CAMDEN LN, BRIDGEVIEW, IL 60455-5500
(708) 790-1303
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-005275
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016-005275
LIC POD
IL
Enumeration date
01/24/2007
Last updated
03/27/2017
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