M Gomez Inc.

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

209008312 Issued in IL

Legal business name

M GOMEZ INC.

Practice address

2266 N Lincoln Ave
Lower Level
Chicago, IL 60614-7600

Phone

(773) 883-3953

Fax

(773) 883-3649

NPI assigned

Feb 13, 2013

Organization subpart

No

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

Authorized official

Name

Meljun GomezNPI 1952618316

Title

Nurse Practitioner

Phone

(773) 883-3953

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Meljun L Gomez, NP-C

  • Adult Health Nurse Practitioner
  • Chicago, IL
  • NPI 1952618316
  NPD (past) Authorized official

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1740529510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 N LINCOLN AVE",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147600",
            "telephone_number": "773-883-3953",
            "fax_number": "773-883-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 N LINCOLN AVE",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147600",
            "telephone_number": "773-883-3953",
            "fax_number": "773-883-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M GOMEZ INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MELJUN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "773-883-3953"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209008312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Primary Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.