Individual
GABRIEL STEFANO GONZALES-PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(813) 777-1507
Mailing address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 355-4000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R79435
AZ
Other
Enumeration date
04/28/2022
Last updated
11/23/2024
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