NPI 1104781905

Jaime Gonzalez

Practitioner Physical Therapy Assistant Gurnee, IL

Practice location

Address: 350 S Greenleaf St STE 403, Gurnee, IL 60031-5709
Phone: (847) 596-7640
Fax: (847) 596-7641
Mailing address: 900 Rand Rd STE 300, Des Plaines, IL 60016-2359

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160-009205 (IL)

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Registry record

NPI: 1104781905
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Dec 2025
Record last updated: 23 Dec 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.