Individual
JOSE SANCHEZ GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 HENRY LUCKOW LN, BELVIDERE, IL 61008-1702
(779) 696-8650
(815) 544-4691
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-153617
IL
390200000X
Student in an Organized Health Care Education/Training Program
125-070965
IL
Other
Enumeration date
07/10/2017
Last updated
01/02/2025
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