Individual
JENNIFER L GONZALEZ
Active
Individual
JENNIFER L GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041309807
IL
363L00000X
Nurse Practitioner
209-008074
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209-003998
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
809840
MEDICARE GROUP NUMBER
IL
Enumeration date
12/22/2009
Last updated
07/21/2022
Update your record
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