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1215154927
MIA M GONZALES
GLEN ELLYN, IL
NPI
1215154927
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Former Name
MIA G MAGSOMBOL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070015338)
Enumeration Date
2007-04-20
Last Update Date
2023-05-26
Business Address
MIA M GONZALES PT
854 ROOSEVELT RD UNIT E10
GLEN ELLYN, IL 60137-6057
Phone number: 630-967-2000
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Mailing Address
MIA M GONZALES PT
PO BOX 713260
CHICAGO, IL 60677-1260
Phone number: 630-469-9200
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