| Michelle Gonzales Llc | |
|
579 N 1st Bank Dr Ste 150 Palatine IL 60067-8102 | |
| (630) 430-7639 | |
| Not Available |
| Full Name | Michelle Gonzales Llc |
|---|---|
| Speciality | Social Worker |
| Location | 579 N 1st Bank Dr Ste 150, Palatine, Illinois |
| Authorized Official Name and Position | Lori Jean Newman (BILLING ADMINISTRATOR) |
| Authorized Official Contact | 7085606653 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Gonzales Llc 28 S Waterford Dr Round Lake IL 60073-9590 Ph: (708) 560-6653 | Michelle Gonzales Llc 579 N 1st Bank Dr Ste 150 Palatine IL 60067-8102 Ph: (630) 430-7639 |
| NPI Number | 1144861865 |
|---|---|
| Provider Enumeration Date | 10/03/2019 |
| Last Update Date | 10/03/2019 |
| Medicare PECOS PAC ID | 0648502930 |
|---|---|
| Medicare Enrollment ID | O20191106002416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144861865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michelle Gonzales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306239520 PECOS PAC ID: 4082046370 Enrollment ID: I20191106002594 |
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