Individual
DR. JAVIER VIDAL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
660 N WESTMORELAND RD, LAKE FOREST, IL 60045-1659
(845) 234-5600
Mailing address
660 N WESTMORELAND RD, LAKE FOREST, IL 60045-1659
(847) 234-5600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036141353
IL
208M00000X
Hospitalist Physician
Primary
036141352
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2014
Last updated
07/21/2022
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