Individual
GISELA M GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
109 FAIRFIELD WAY STE 103, BLOOMINGDALE, IL 60108-1522
(630) 894-1054
(630) 894-3280
Mailing address
902 FLORENCE DR, PARK RIDGE, IL 60068-2108
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036083477
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083477
—
IL
01
—
30-0482979
COMMERCIAL
IL
Enumeration date
10/04/2006
Last updated
12/09/2019
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