Individual
AMIKO GOMEZ HIDAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 S WOOD ST, CHICAGO, IL 60608-1202
(312) 996-2000
Mailing address
525 W HAWTHORNE PL APT 2503, CHICAGO, IL 60657-2960
(773) 879-8540
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
10/01/2022
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