Individual
DR. BRIAN PATRICK GOMOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-2002
(708) 202-2024
Mailing address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-2002
(708) 202-2024
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
036130084
IL
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
036130084
IL
2084P0800X
Psychiatry Physician
Primary
036.130084
IL
Other
Enumeration date
03/27/2009
Last updated
03/18/2021
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