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Organization
ROSE GOMEZ, M.D.,P.C.
Active
Organization
ROSE GOMEZ, M.D.,P.C.
Active
Parent organization
PARENT ORGANIZATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARENT ORGANIZATION
Authorized official
ROSE GOMEZ M.D.,P.C. (PRESIDENT)
(708) 361-1616
Entity
Organization
Contact information
Practice address
7600 W COLLEGE DR, PALOS HEIGHTS, IL 60463-1256
(708) 361-1616
(708) 361-1502
Mailing address
875 N MICHIGAN AVE, SUITE 3710, CHICAGO, IL 60611-1803
(312) 951-2826
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
36056870
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021609583
BLUE CROSS
IL
Enumeration date
11/16/2007
Last updated
03/27/2008
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