Organization
M. GOMEZ INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELJUN L GOMEZ NP-C (PRESIDENT)
(773) 744-2935
Entity
Organization
Contact information
Practice address
2266 N LINCOLN AVE LOWR LEVEL, CHICAGO, IL 60614-7600
(773) 883-3953
(773) 883-3649
Mailing address
1040 W ADAMS ST UNIT 346, CHICAGO, IL 60607-3087
(773) 744-2935
(773) 883-3649
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.008312
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952618316
INDIVIDUAL NPI
IL
Enumeration date
09/08/2010
Last updated
09/08/2010
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