Healthcare Provider Details

I. General information

NPI: 1568744001
Provider Name (Legal Business Name): KIMBERLY LIM GOMEZ PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2011
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E US ROUTE 6
MORRIS IL
60450-8920
US

IV. Provider business mailing address

333 US-6
MORRIS IL
60450
US

V. Phone/Fax

Practice location:
  • Phone: 815-942-1662
  • Fax: 815-942-5458
Mailing address:
  • Phone: 815-942-1662
  • Fax: 815-942-5458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.290592
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: