MEDICARE: PAULIANNE CZESCA BELEN GONZALES NP

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209033988	IL
2	363LF0000X	Family Nurse Practitioner	209016250	IL

General Provider Information

NPI Number	:	1679083471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULIANNE CZESCA BELEN GONZALES NP

Provider Business Mailing Address
First Line	:	PO BOX 129
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60544-0129
Country	:	US
Telephone Number	:	800-843-0355
Fax Number	:	815-834-7211

Provider Business Practice Location Address
First Line	:	136 OGDEN AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-2322
Country	:	US
Telephone Number	:	630-566-4810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	11/17/2025

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