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General NPI Number Information
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NPI Number | 1154636959
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Entity Type | Organization
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Legal Business Name | ASSOCIATED FAMILY PHYSICIANS, SC
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 1635 N ARLINGTON HEIGHTS RD 203
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-3944
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Country | US
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Telephone | 847-392-1500
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Fax | 847-392-9706
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Provider Business Mailing Address
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Address Line | 1635 N ARLINGTON HEIGHTS RD 203
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-3944
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Country | US
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Telephone | 847-392-1500
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Fax | 847-392-9706
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAMON ANGEL GONZALEZ
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Credential | MD
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Telephone | 847-392-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036094195
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License Number State | IL
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