Individual
TEOFILA GONZALES MESINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6016 W BARRY AVE, CHICAGO, IL 60634-5105
(773) 818-6775
(773) 622-8608
Mailing address
6016 W BARRY AVE, CHICAGO, IL 60634-5105
(773) 818-6775
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363799312001
—
IL
Enumeration date
10/17/2007
Last updated
10/17/2007
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