Mosquera, Gustavo

Mosquera, Gustavo is an individual health care provider with primary practice located at 101 E Plummer Blvd , Chatham IL 62629-8047. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mosquera, Gustavo can be contacted via phone (217) 483-3487.

Contact Information

Primary practice address
101 E Plummer Blvd Chatham IL 62629-8047
Fax: (217) 483-8151
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036086050 Illinois

Profile Details

NPI number 1033395629
LBN Legal business name Mosquera, Gustavo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 14th, 2008
Last updated Feb 25th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033395629 NPPES
Illinois MEDICAID 036086050

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