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1982073961
JERRY GONZALEZ
WAUKEGAN, IL
NPI
1982073961
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172A00000X Driver
(Licence: IL 45-3068110)
Enumeration Date
2015-09-19
Last Update Date
2015-09-19
Business Address
-- JERRY GONZALEZ
1222 NORTH AVE
WAUKEGAN, IL 60085-2942
Phone number: 847-980-2410
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Mailing Address
-- JERRY GONZALEZ
1222 NORTH AVE
WAUKEGAN, IL 60085-2942
Phone number: 847-980-2410
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