Healthcare Provider Details

I. General information

NPI: 1093686057
Provider Name (Legal Business Name): ANA MARIA VASQUEZ GOMEZ LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 N WILKE RD STE A
ARLINGTON HEIGHTS IL
60004-1451
US

IV. Provider business mailing address

3115 N WILKE RD STE A
ARLINGTON HEIGHTS IL
60004-1451
US

V. Phone/Fax

Practice location:
  • Phone: 315-217-1868
  • Fax:
Mailing address:
  • Phone: 315-217-1868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.001914
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: