MRS. BLAKE KATHLEEN GOMEZ (NPI# 1447723796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447723796 |
Entity Type | Individual |
Full Name | MRS. BLAKE KATHLEEN GOMEZ |
Other Name | MISS BLAKE KATHLEEN WINCENTSEN |
Credential | CPNP-AC |
Practice Address |
1675 Dempster St Park Ridge IL 60068-1110 |
Mailing Address |
10860 Kingsborough Trl Cottage Grove MN 55016-4660 |
Practice Telephone | 8553125437 |
Mailing Telephone | 6517695002 |
Enumeration Date | 2019-01-09 |
Last Update Date | 2019-01-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209018598 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LP0222X |
Nurse Practitioner Specialization: Pediatrics, Critical Care |
209018598 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
4400 W 95th St, Oak Lawn, IL 604532654 | 7086848000 |
Street Address |
1675 DEMPSTER ST |
City | PARK RIDGE |
State | IL |
Zip Code | 60068-1110 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417932526 | David G Thoele | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2005-12-12 |
1811594088 | Sara Schankerman | Occupational Therapist | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-10-01 |
1598394454 | Alyse Marie Kaml | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-04-03 |
1386273399 | Sharon Marie Figliulo | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-04-02 |
1033748181 | Joshua Raven | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-04-01 |
1043848310 | Justin Henry Arollado Figueroa | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-03-31 |
1043848344 | Elizabeth Emily Onishchenko | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-03-31 |
1992333496 | Catherine Siew | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-03-30 |
1184252850 | Jessica Nilsen | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-03-30 |
1508494287 | Timothy Michael Marshall | Pediatrics | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2020-03-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
Find all providers in zip 60068 |
Taxonomy Code | 363LP0222X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics, Critical Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144764986 | Kathleen Krawzak | Nurse Practitioner | 1675 Dempster St, Park Ridge, IL 60068-1110 | 2016-12-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942801071 | Kathrine Sunstedt | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 201, Peoria, IL 61603-3112 | 2020-11-04 |
1245837863 | Emily Anne Whitlow | Nurse Practitioner | 5023 W Agatite Ave Unit 1, Chicago, IL 60630-3907 | 2020-10-06 |
1508271727 | Amy Wilhelmi | Nurse Practitioner | 21 Carey Ln, Streamwood, IL 60107-6662 | 2014-06-26 |
1700115235 | Janis Marie Quinn | Nurse Practitioner | 225 E. Chicago Ave, Chicago, IL 60611-2605 | 2009-12-11 |
1629213624 | Karriann Marie Longtin | Nurse Practitioner | 400 S Kennedy Dr Ste 900, Bradley, IL 60915-2683 | 2008-12-05 |
1649272154 | Beth Nachtsheim Bolick | Nurse Practitioner | 1653 W Congress Pkwy, Chicago, IL 60612-3833 | 2005-08-15 |
1942828306 | Stephanie Allison Gierman | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-07-11 |
1851925622 | Lauren Alyssa Shaughnessy | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-03-02 |
1326683236 | Brittany Brennan | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2019-11-14 |
1093378986 | Trudy Jean Johnson | Nurse Practitioner | 5841 S Maryland Ave # Mc1145, Chicago, IL 60637-1443 | 2019-04-17 |
Find all providers with the same taxonomy |
City | PARK RIDGE |
Zip Code | 60068 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.