Individual
RICHARD P GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
036083260
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000044493
—
AL
05
—
00120450
—
MS
01
—
020042466
RAILROAD MEDICARE PTAN
AL
05
—
1151181
—
LA
01
—
17-10433
UNITED HEALTH CARE
AL
05
—
255987100
—
FL
01
—
51044493
BLUE CROSS
AL
01
—
51592788
BCBS - 2451 FILLINGIM
AL
01
—
51593901
BCBS - 575 STANTON ROAD
AL
Enumeration date
05/30/2006
Last updated
03/02/2016
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