Healthcare Provider Details

I. General information

NPI: 1164823779
Provider Name (Legal Business Name): GOMEZ MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N RANDALL RD STE 155
ELGIN IL
60123-7805
US

IV. Provider business mailing address

1600 N RANDALL RD STE 155
ELGIN IL
60123-7805
US

V. Phone/Fax

Practice location:
  • Phone: 224-856-2300
  • Fax: 224-856-2305
Mailing address:
  • Phone: 224-856-2300
  • Fax: 224-856-2305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number036066870
License Number StateIL

VIII. Authorized Official

Name: DR. ANGEL GOMEZ
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 847-894-0755