GOMEZ MEDICAL GROUP INC NPI 1164823779

NPI Information

NPI: 1164823779
Provider Name: GOMEZ MEDICAL GROUP, INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D2089265

Address:
530 N MCLEAN BLVD
ELGIN, IL
ZIP 60123
Phone: (847) 894-0755
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GOMEZ MEDICAL GROUP, INC is a primary care clinic center in Elgin, IL. GOMEZ MEDICAL GROUP, INC NPI is 1164823779. The provider is registered as an organization entity type.

The provider's business location address is:

530 N MCLEAN BLVD
ELGIN, IL
ZIP 60123-275
Phone: (847) 894-0755

The provider's authorized official is Angel Gomez .
The authorized official title is President/owner and has the following contact phone number (847) 894-0755.

The CLIA number assigned to this NPI record is 14D2089265 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/15/2014 and was last updated on 9/15/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	036066870	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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