Individual
GABRIEL MUNOZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526
(217) 876-3000
Mailing address
P.O. BOX 587, DECATUR, IL 62523
(800) 815-3365
(631) 321-4235
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101891-2
—
IL
01
—
05823820
BCBS OF ILLINOIS GROUP ID
IL
Enumeration date
10/05/2006
Last updated
07/09/2007
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