Individual provider Active NPI

Victoria P Gomez

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1417043464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036065495 Issued in IL
Practice address
Chicago Department of Public Health
333 S State Street Revenue #200
Chicago, IL 60604
Phone
(312) 747-9443
Fax
(312) 747-9447
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036065495 IL Primary

Addresses

Primary practice location

Chicago Department of Public Health
333 S State Street Revenue #200
Chicago, IL 60604

Mailing address

Chicago Department of Public Health
333 S State Street Revenue #200
Chicago, IL 60604
Phone (312) 747-9443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036065495ILMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417043464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHICAGO DEPARTMENT OF PUBLIC HEALTH",
            "address_2": "333 S STATE STREET REVENUE #200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60604",
            "telephone_number": "312-747-9443",
            "fax_number": "312-747-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHICAGO DEPARTMENT OF PUBLIC HEALTH",
            "address_2": "333 S STATE STREET REVENUE #200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60604",
            "telephone_number": "312-747-9443",
            "fax_number": "312-747-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "VICTORIA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036065495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.