Individual
MS. MARY ASTOR GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2300 N CHILDRENS PLZ, CHICAGO, IL 60614-3363
(773) 880-3816
Mailing address
2300 N CHILDRENS PLZ, CHICAGO, IL 60614-3363
(773) 880-3816
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209-004575
IL
Other
Enumeration date
08/20/2006
Last updated
06/11/2010
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