Individual
JAVIER ALFONSO GOMEZ VALENCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-6000
Mailing address
1900 W POLK ST, CHICAGO, IL 60612-3723
(312) 864-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036130372
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036-130372
IL
207UN0901X
Nuclear Cardiology Physician
036-130372
IL
Other
Enumeration date
09/08/2010
Last updated
04/23/2021
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