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General NPI Number Information
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NPI Number | 1730999541
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Entity Type | Individual
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Provider Name | SANDRA LUZ GONZALEZ MFT
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Gender | Female
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1500 E LINCOLN HWY STE A
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City | DEKALB
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State | IL
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Zip | 60115-3990
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Country | US
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Telephone | 779-702-5663
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Fax | 779-256-0204
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Provider Business Mailing Address
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Address Line | 209 LINDER LN
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City | ROCHELLE
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State | IL
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Zip | 61068-1115
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Country | US
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Telephone | 815-517-3296
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 208-001067
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License Number State | IL
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