Individual
MRS. ENRIQUETA R GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
900 TECHNOLOGY WAY STE 280, LIBERTYVILLE, IL 60048-5364
(847) 549-0588
Mailing address
7438 W JONQUIL TER, NILES, IL 60714-3104
(847) 414-3869
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209017095
IL
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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