Individual
DR. LUIS EDWIN GAONA GARZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
815 MARCHESANO DR, ROCKFORD, IL 61102-3521
(779) 696-5950
Mailing address
815 MARCHESANO DR, ROCKFORD, IL 61102-3521
(779) 696-5950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036168560
IL
208D00000X
General Practice Physician
036.168560
IL
Other
Enumeration date
03/22/2021
Last updated
09/25/2024
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