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Mireya Gamboa
Developmental Disabilities Clinic/Center in Chicago, Illinois
NPI 1144919804

Mireya Gamboa is a Developmental Disabilities Clinic/Center based in Chicago, IL and is specialized in Developmental Disabilities. Mireya Gamboa practices in Chicago, IL. The NPI Number for Mireya Gamboa is 1144919804 and holds a License No. (Illinois).

The current practice location address for Mireya Gamboa is 5102 S Menard Ave, Chicago, IL and can be reached out via phone at 773-671-1520. You can also correspond with Mireya Gamboa through the mailing address at 5102 S MENARD AVE, CHICAGO, IL - 60638 (mailing address contact number: 773-671-1520).

Location: 5102 S Menard Ave, Chicago, IL, 60638
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144919804
Provider Name
Mireya Gamboa
Credential
Provider Entity Type
Individual
Gender
Female
Address
5102 S Menard Ave, Chicago, IL, 60638
Phone Number
773-671-1520
Fax Number
Provider Enumeration Date
05/08/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5102 S Menard Ave
City
Chicago
State
Illinois
Zip
60638
Phone Number
773-671-1520
Fax Number
person
Provider Business Mailing Address Details
Address
5102 S Menard Ave
City
Chicago
State
Illinois
Zip
60638
Phone Number
773-671-1520
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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