Individual
DR. ENRICO GONONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 E STATE ST, ROCKFORD, IL 61104-2231
(815) 972-1030
(815) 972-1092
Mailing address
1221 E STATE ST, ROCKFORD, IL 61104-2231
(815) 972-1030
(815) 972-1092
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125054087
IL
Other
Enumeration date
09/05/2008
Last updated
09/05/2008
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