DR. FERNANDO LUIS GONZALEZ (NPI# 1558352609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558352609 |
| Entity Type | Individual |
| Full Name | DR. FERNANDO LUIS GONZALEZ |
| Credential | MD |
| Practice Address |
1000 Health Center Dr Ste 305 Mattoon IL 61938 |
| Mailing Address |
1005 Health Center Dr Ste 201 Mattoon IL 61938-4693 |
| Practice Telephone | 2172584186 |
| Practice Fax Number | 2173484185 |
| Mailing Telephone | 2172386055 |
| Mailing Fax Number | 2172582216 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2019-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036-083284 | IL | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | MD2012-0231 | NM | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 01060971A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200527960 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1010 Spruce St, Espanola, NM 87532 | 5053670360 | 5053674495 |
| 1104 W Evergreen Ave, Effingham, IL 624011710 | 2172584186 | 2173484185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891273900 | Fernando Gonzalez IIi | Social Worker | 1840 Oak Ave Ste 320, Evanston, IL 60201-3680 | 2018-07-31 |
| 1568988848 | Fernando Garcia Gonzalez | Chiropractor | 8101 Airport Blvd Ste A, Houston, TX 77061-4138 | 2017-08-17 |
| 1215100250 | Fernando Luis Gonzalez | Personal Emergency Response Attendant | 167 Calle Mimosa, Santa Maria, San Juan, PR 00927-6215 | 2008-04-10 |
| 1912026972 | Fernando Gonzalez | Pharmacist | 2472 Flatbush Ave, Brooklyn, NY 11234-5045 | 2007-03-28 |
| 1700942018 | Fernando Gonzalez | Pharmacy Technician | Carr 348 Km 5.2, Bo Malesa, Mayaguez, PR 00680 | 2006-12-29 |
| 1043239619 | Fernando Francisco Gonzalez | Pediatrics | 501 Parnassus Ave, San Francisco, CA 94143-2208 | 2006-07-18 |
| 1750324778 | Fernando Gonzalez Jr. | Counselor | 9150 Huebner Rd., #210, San Antonio, TX 78240 | 2006-06-14 |
| 1912223025 | Fernando Gonzalez | Pain Medicine | 111 Maltese Dr, Middletown, NY 10940-2115 | 2010-04-14 |
| 1568680775 | Fernando Gonzalez | Psychiatry & Neurology | 4175 W 20th Ave, Hialeah, FL 33012-5874 | 2007-04-23 |
| 1851433312 | Fernando Gonzalez | Clinical Neuropsychologist | 7601 Imperial Hwy, Harriman Building 226, Downey, CA 90242-3456 | 2007-02-13 |
| Street Address |
1000 HEALTH CENTER DR STE 305 |
| City | MATTOON |
| State | IL |
| Zip Code | 61938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487948303 | Jodi M. Morrisey | Nurse Practitioner | 1000 Health Center Dr Ste 305, Mattoon, IL 61938-4644 | 2011-06-08 |
| 1740297803 | David F Didomenico | Urology | 1000 Health Center Dr Ste 305, Mattoon, IL 61938-9261 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
| Find all providers in zip 61938 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154861334 | Sarah Bush Lincoln Health Center | Urology | 1000 Health Center Dr, Suite 305, Mattoon, IL 61938-9253 | 2017-03-07 |
| 1740297803 | David F Didomenico | Urology | 1000 Health Center Dr Ste 305, Mattoon, IL 61938-9261 | 2006-08-02 |
| 1861416372 | Roger Kent Rives | Urology | 500 Health Center Dr, Suite 305, Mattoon, IL 61938-9258 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1912436015 | Robert Ara Petrossian | Urology | 301 N 8th St # 4b143c, Springfield, IL 62701-1041 | 2017-06-12 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1619337912 | George Robert Buckun | Urology | 930 Rogers St., #301, Downers Grove, IL 60515 | 2016-02-29 |
| 1275991606 | Nicole Alyssa Hamilton | Urology | 22285 N Pepper Rd Ste 201, Lake Barrington, IL 60010-2540 | 2016-01-30 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1386053759 | Ramiro Felix Prudencio | Urology | 1200 Broadmeadow Rd, Winnetka, IL 60093-3707 | 2014-08-10 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.