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NPI Code Detail

MEDICARE: WENDY DANIELLA GONZALEZ

MEDICARE: WENDY DANIELLA GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianIL

General Provider Information

NPI Number : 1548117377
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY DANIELLA GONZALEZ
Provider Business Mailing Address
First Line : 150 E DARTMOOR DR
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-8710
Country : US
Telephone Number : 888-308-3728
Fax Number :
Provider Business Practice Location Address
First Line : 150 E DARTMOOR DR
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-8710
Country : US
Telephone Number : 888-308-3728
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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