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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