Individual
MR. TIMOTHY JORGE GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 W FRONTAGE RD STE 3825, NORTHFIELD, IL 60093-1262
(847) 821-9346
(847) 821-0545
Mailing address
7406 INGLENOOK LN, GURNEE, IL 60031-5126
(224) 616-9460
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178020754
IL
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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