Individual
MR. JOSE MARIO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5050 S KEDZIE AVE, CHICAGO, IL 60632-3009
(773) 476-6323
Mailing address
1350 W FULLERTON AVE, UNIT 404, CHICAGO, IL 60614-2198
(773) 244-3361
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.039540
IL
Other
Enumeration date
02/28/2010
Last updated
02/28/2010
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