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Individual

JAMES EDWARD GONZALES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CST/CSFA

Contact information

Practice address
1515 S PRAIRIE AVE, 1302, CHICAGO, IL 60605-3043
(708) 705-3772
Mailing address
1515 S PRAIRIE AVE, 1302, CHICAGO, IL 60605-3043
(708) 705-3772

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary

Other

Enumeration date
03/01/2012
Last updated
03/01/2012
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