Individual
DR. CARLOS A GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4438 N MIWAUKEE AVE, CHICAGO, IL 60630-6063
(773) 205-8200
(773) 205-1222
Mailing address
2856 N BURLING ST, CHICAGO, IL 60657-5848
(773) 205-8200
(773) 205-1222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036086306
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086306
—
IL
01
—
364376595
TAX ID
IL
Enumeration date
09/17/2006
Last updated
02/10/2020
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