Individual
IRVING GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1921 DAVIS AVE, WHITING, IN 46394-1820
(219) 659-3522
(219) 554-4571
Mailing address
2604 S EMERALD AVE, APARTMENT C, CHICAGO, IL 60616-2525
(847) 791-0240
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096003543
IL
2255A2300X
Athletic Trainer
Primary
36002219A
IN
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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