Gamboa, Mireya

Gamboa, Mireya is an sole proprietor health care provider with primary practice located at 5102 S Menard Ave , Chicago IL 60638. She recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as her primary health care specialty. Gamboa, Mireya can be contacted via phone (773) 671-1520.

Contact Information

Primary practice address
5102 S Menard Ave Chicago IL 60638
Phone: (773) 671-1520
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X

Profile Details

NPI number 1144919804
LBN Legal business name Gamboa, Mireya
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 8th, 2023
Last updated May 8th, 2023 - about last year

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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