Individual
JULIANA GONZALES-HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
360 STATION DR, CRYSTAL LAKE, IL 60014
(815) 338-6600
(815) 455-8044
Mailing address
360 STATION DR, CRYSTAL LAKE, IL 60014-7978
(815) 338-6600
(815) 455-8044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209013286
IL
363LF0000X
Family Nurse Practitioner
Primary
209.0132.86
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209013286
STATE LICENSE
IL
Enumeration date
12/30/2015
Last updated
10/19/2018
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