Individual
DR. PEDRO JUAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 ASBURY AVE, EVANSTON, IL 60202-2724
(847) 316-3320
(847) 316-2915
Mailing address
401 N MICHIGAN AVENUE, SUITE 1200, CHICAGO, IL 60611-4264
(312) 635-0973
(813) 290-9691
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036135725
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036135725
LICENSE NO
IL
05
—
036135725
—
IL
01
—
P01402298
RR MEDICARE
IL
Enumeration date
07/24/2010
Last updated
10/29/2015
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