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Individual

GABRIEL MENDOZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
7101 N CICERO AVE STE 202, LINCOLNWOOD, IL 60712-2143
(773) 433-6210
(866) 744-0950
Mailing address
7101 N CICERO AVE STE 202, LINCOLNWOOD, IL 60712-2143
(773) 433-6210
(866) 744-0950

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043110552
IL

Other

Enumeration date
09/08/2022
Last updated
01/03/2023
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