Organization
COUNTY OF PUTNAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HECTOR MANUEL GOMEZ BBA, ACCOUNTING (PUBLIC HEALTH ADMINISTRATOR)
(815) 872-5091
Entity
Organization
Contact information
Practice address
220 E. HIGH ST, HENNEPIN, IL 61327
(815) 925-7326
(815) 925-7001
Mailing address
220 E HIGH ST STE 101, HENNEPIN, IL 61327-9515
(815) 925-7326
(815) 925-7001
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
02/02/2007
Last updated
06/25/2021
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