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General NPI Number Information
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NPI Number | 1699260653
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Entity Type | Individual
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Provider Name | CHRIS E GONZALES MS, NCC, LPC
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Gender | Male
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 106 S. LINCOLNWAY F
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City | NORTH AURORA
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State | IL
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Zip | 60542-1663
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Country | US
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Telephone | 630-267-2728
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Fax | 630-801-1675
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Provider Business Mailing Address
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Address Line | 1484 CAMBRIA DR UNIT 4
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City | DEKALB
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State | IL
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Zip | 60115-1084
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Country | US
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Telephone | 630-267-2728
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | IL
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