Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | IL | |
N | 207VX0000X | Obstetrician | IL |
NPI | 1063449775 |
---|---|
Provider Name | Dr. Isabel Gomez |
First Address | Park Ridge, IL 60068-1186 |
Second Address | Park Ridge, IL 60068-1186 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 30/07/2007 |