Individual
JOSE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8387
Mailing address
1955 S CENTRAL AVE, CICERO, IL 60804-2298
(773) 512-9054
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IL
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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