Cristina Marino Gonzales, R.N.

Individual provider Active NPI Driver · Mt Prospect, IL

NPI 1487778619 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487778619
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
DO7106328 (IL)
Practice address
1022 N Boxwood Dr
Mt Prospect, IL 60056-1204
Phone
(847) 707-4137
Fax
(847) 368-7889
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
DO7106328ILMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X DO7106328 IL Yes

Addresses

Primary practice location

1022 N Boxwood Dr
Mt Prospect, IL 60056-1204

Mailing address

1022 N Boxwood Dr
Mt Prospect, IL 60056-1204
Phone (847) 707-4137

Other providers in Mt Prospect, IL

All providers in Mt Prospect, IL · Driver in Illinois

Sources for this page

Verify at the official NPI Registry.