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NPI Code Detail

MEDICARE: MS. CAITLIN ANNE GOMEZ M.S., CCC-SLP

MEDICARE: MS. CAITLIN ANNE GOMEZ M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114087492OTHERAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION

General Provider Information

NPI Number : 1700390952
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAITLIN ANNE GOMEZ M.S., CCC-SLP
Provider Business Mailing Address
First Line : 9937 S CICERO AVE APT 102
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-4062
Country : US
Telephone Number : 708-207-4033
Fax Number :
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1443
Country : US
Telephone Number : 773-702-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2017
Last Update Date : 03/24/2026

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