Jerry Gonzalez

NPI #1982073961 in Waukegan, Illinois

Provider Information

NPI Number: 1982073961
Entity Type: Individual
Name: Jerry Gonzalez
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Sep 19, 2015
Last Updated: Sep 19, 2015

Practice Location

Address: 1222 NORTH AVE
City: Waukegan
State: Illinois
ZIP Code: 60085-2942
Phone: (847) 980-2410

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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