Gonzalez, Sergio
Gonzalez, Sergio is an individual health care provider with primary practice located at 2160 S First Ave 101-1740, Maywood IL 60153. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gonzalez, Sergio can be contacted via phone (708) 216-9000.Contact Information
Primary practice address
2160 S First Ave 101-1740
Maywood IL 60153
Phone: (708) 216-9000
Fax: (708) 216-9033
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 36110087 | Illinois |
Profile Details
| NPI number | 1659342939 |
|---|---|
| LBN Legal business name | Gonzalez, Sergio |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 27th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659342939 | NPPES |
| Illinois | MEDICAID | 36110087 |
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