Mireya Gamboa
Mireya Gamboa is a Developmental Disabilities Clinic/Center in Chicago, Illinois. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
5102 S Menard AveChicago, IL 60638
Phone: (773) 671-1520
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Specialties & licences
| Developmental Disabilities Clinic/Center (primary) | Taxonomy 261QD1600X |
|---|
Record details
| NPI number | 1144919804 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | May 8, 2023 |
| Last updated in NPPES | May 8, 2023 |
| Certification date | May 7, 2023 |
| Mailing address | 5102 S Menard Ave, Chicago, IL 60638 |
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