Gamboa, Guillermo

Gamboa, Guillermo is an sole proprietor health care provider with primary practice located at 10434 S Kedzie Ave , Chicago IL 60655-2018. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Gamboa, Guillermo can be contacted via phone (773) 445-2700.

Contact Information

Primary practice address
10434 S Kedzie Ave Chicago IL 60655-2018
Phone: (773) 445-2700
Fax: (773) 445-2325
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X Illinois
Eye and Vision Services Providers / Sports Vision 152WS0006X Illinois
Eye and Vision Services Providers / Vision Therapy 152WV0400X Illinois

Profile Details

NPI number 1982897005
LBN Legal business name Gamboa, Guillermo
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2007
Last updated Aug 22nd, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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