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General NPI Number Information
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NPI Number | 1053632331
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Entity Type | Individual
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Provider Name | JOSEPHINE L. GONZALES-CHUA PT
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Gender | Female
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 1790 NATIONS DRIVE SUITE 107
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City | GURNEE
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State | IL
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Zip | 60031-9175
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Country | US
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Telephone | 224-548-8114
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Fax | 224-494-4023
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Provider Business Mailing Address
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Address Line | 1790 NATIONS DR SUITE 107
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City | GURNEE
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State | IL
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Zip | 60031-9164
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Country | US
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Telephone | 224-548-8114
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Fax | 224-944-0236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 070006532
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License Number State | IL
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