MEDICARE: DR. MARIO F. GONZALEZ D.C.

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	111N00000X	Chiropractor	38010869	IL

General Provider Information

NPI Number	:	1871645572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIO F. GONZALEZ D.C.

Provider Business Mailing Address
First Line	:	621 MADISON ST STE C
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-2203
Country	:	US
Telephone Number	:	773-470-6729
Fax Number	:	312-237-3837

Provider Business Practice Location Address
First Line	:	621 MADISON ST STE C
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-2203
Country	:	US
Telephone Number	:	847-859-2563
Fax Number	:

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	05/05/2026

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