Provider Demographics
NPI:1881889558
Name:GARCIA GONZALEZ, JOSE MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MARIA
Last Name:GARCIA GONZALEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:MARIA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2454 E DEMPSTER ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5315
Mailing Address - Country:US
Mailing Address - Phone:847-299-0700
Mailing Address - Fax:847-390-0616
Practice Address - Street 1:1114 AVE JESUS T PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1722
Practice Address - Country:US
Practice Address - Phone:787-781-3020
Practice Address - Fax:787-781-3020
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036127765207WX0107X
PR23987207W00000X
IL036.127765207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400173219Medicare PIN