Guillermo Gamboa (NPI# 1982897005, PAC ID# 0446412639) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1982897005 |
| PAC ID by PECOS | 0446412639 |
| Professional Enrollment ID | I20120504000307 |
| Full Name | Guillermo Gamboa |
| Organization Legal Name | BUSH FAMILY EYE CARE LLC |
| Address |
10434 S Kedzie Ave Chicago IL 60655-2018 |
| Phone Number | 7734452700 |
| Gender | M |
| Medical School | ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO |
| Graduation Year | 2003 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 0749410843 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 10434 S Kedzie Ave, Chicago, IL 60655-2018 | 7734452700 | BUSH FAMILY EYE CARE LLC |
| 2252 W Cermak Rd, Chicago, IL 60608-3917 | 7738471581 | PEREZ EYE CARE, INC |
| 25 E Washington St, Suite 820, Chicago, IL 60602-1700 | 3123320921 | PEREZ EYE CARE, INC |
| Organization Legal Name | BUSH FAMILY EYE CARE LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eileen M Bush | Optometry | Bush Family Eye Care LLC | 10434 S Kedzie Ave, Chicago, IL 60655-2018 |
| Elizabeth J Bush | Optometry | Bush Family Eye Care LLC | 10434 S Kedzie Ave, Chicago, IL 60655-2018 |
| Street Address |
10434 S KEDZIE AVE |
| City | CHICAGO |
| State | IL |
| Zip | 60655-2018 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eileen M Bush | Optometry | Bush Family Eye Care LLC | 10434 S Kedzie Ave, Chicago, IL 60655-2018 |
| Elizabeth J Bush | Optometry | Bush Family Eye Care LLC | 10434 S Kedzie Ave, Chicago, IL 60655-2018 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathleen M Daly | Podiatry | 10431 S Kedzie, Chicago, IL 60655-2017 | |
| Wayne E Cooper | Podiatry | Preferred Podiatry Group PC | 10444 S Kedzie Ave, Chicago, IL 60655-2018 |
| Sargon B Odisho | Chiropractic | 3139 W 111th St, Chicago, IL 60655-2205 | |
| Julia Philip-kuli | Family Medicine | Little Company of Mary Affiliated Services Inc | 10961 S Kedzie Ave, Chicago, IL 60655-2219 |
| Thomas P Toulios | Chiropractic | 11001 S Kedzie Ave, Chicago, IL 60655-2221 | |
| Michael W Hausch | Chiropractic | 11001 S Kedzie Ave, Chicago, IL 60655-2221 | |
| George Michael Nista | Optometry | 3135 W 111th St, Chicago, IL 60655-2223 | |
| Dijana Mirkovic | Podiatry | Chicagoland Foot and Ankle, PC | 3260 W 111th St, Chicago, IL 60655-2729 |
| Mark D Sack | Podiatry | 3216 W 115th St, Chicago, IL 60655-2805 | |
| Eileen Mccann | Nurse Practitioner | Saint Xavier University | 3700 W 103rd St, Chicago, IL 60655-3105 |
| Find all physicians in zip 60655 | |||
| City | CHICAGO |
| Zip Code | 60655 |
| Specialty | OPTOMETRY |
| City + Specialty | CHICAGO + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.