Enriqueta R Gomez, NP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209017095 Issued in IL

Practice address

900 Technology Way Ste 280
Libertyville, IL 60048-5364

Phone

(847) 549-0588

NPI assigned

Mar 7, 2019

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL

  Medicare reassignment NPD
• Integrated Home Healthcare Services, Corp

  • Home Health Agency
  • Libertyville, IL
  • NPI 1477625234
  NPD (past)

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1770041832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7438 W JONQUIL TER",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143104",
            "telephone_number": "847-414-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TECHNOLOGY WAY STE 280",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485364",
            "telephone_number": "847-549-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ENRIQUETA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209017095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Gockley, LPC
• Amanda Kathleen Gold, MSN, RN
• Nathan E Goldberg, O.D.
• Eric Goldstein
• Abigail Gomez
• Alyssa Gonzales
• Lisette Gonzalez
• Evan B Goodman, D.D.S.
• Michelle Goodman, MPT
• Dale S Gordon, MD

• Gerontology Nurse Practitioner in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.