Angelica Elizabeth Gomez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160005103 Issued in IL

Practice address

1219 W Roosevelt Rd
Maywood, IL 60153-4046

Phone

(888) 584-7888

Fax

(708) 531-7936

NPI assigned

Apr 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1578820049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 OAK AVE",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "605131317",
            "telephone_number": "708-769-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 W ROOSEVELT RD",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601534046",
            "telephone_number": "888-584-7888",
            "fax_number": "708-531-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ANGELICA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160005103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Golden
• Kate Louise Goldhaber, PHD
• Jay Goldsher, MD
• Lucy Elaine Gomez Timana, MD
• Angela Teresa Gomez-Lam, M.D.
• Michael S Gong, MD
• Yiran Gong, MD
• Ilana Gonik, PHD
• Gustavo Adolfo Gonzalez Garcia, M.D.
• Tania Cristina Gonzalez-Rivera, MD, MPH

• Physical Therapy Assistant in Maywood, IL
• Providers in Maywood, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.