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General NPI Number Information
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NPI Number | 1164823779
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Entity Type | Organization
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Legal Business Name | GOMEZ MEDICAL GROUP, INC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 1600 N RANDALL RD STE 155
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City | ELGIN
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State | IL
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Zip | 60123-7805
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Country | US
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Telephone | 224-856-2300
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Fax | 224-856-2305
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Provider Business Mailing Address
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Address Line | 1600 N RANDALL RD STE 155
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City | ELGIN
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State | IL
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Zip | 60123-7805
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Country | US
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Telephone | 224-856-2300
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Fax | 224-856-2305
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ANGEL GOMEZ
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Credential | M.D.
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Telephone | 847-894-0755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 036066870
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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