MIREYA GAMBOA
NPI 1144919804
Clinic/Center - Developmental Disabilities in Chicago, IL

Q: What is Mireya Gamboa's NPI number?

The NPI number for Mireya Gamboa is 1144919804. It was assigned to this individual provider in the NPPES registry on May 8, 2023.

Q: What is Mireya Gamboa's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Developmental Disabilities, with taxonomy code 261QD1600X.

Q: When was this NPI record last updated?

The NPPES record for Mireya Gamboa was last updated on May 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 08, 2023

5102 S MENARD AVE, CHICAGO, IL 60638(773) 671-1520 Get Directions Write a Review

NPPES record last updated: May 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mireya Gamboa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIREYA GAMBOA (NPI 1144919804) is an individual developmental disabilities provider in Chicago, Illinois and active in the NPI registry since May 2023.

NPPES Registry Identity

NPI1144919804

Entity TypeIndividualFemale

Primary Taxonomy261QD1600X

Provider Legal NameMIREYA GAMBOA

Location Address5102 S MENARD AVEChicago, IL 60638

Mailing Address5102 S Menard AveChicago, IL 60638 · (773) 671-1520

Phone(773) 671-1520

Sole ProprietorYes

Enumeration DateMay 8, 2023

NPPES CertifiedMay 7, 2023

✔ NPI 1144919804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Developmental DisabilitiesAmbulatory Health Care Facilities

Taxonomy Code261QD1600X

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.).

5102 S MENARD AVE, Chicago, IL 60638

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mireya Gamboa's NPI number?

The NPI number for Mireya Gamboa is 1144919804. It was assigned to this individual provider in the NPPES registry on May 8, 2023.

Where is Mireya Gamboa located?

Mireya Gamboa practices at 5102 S Menard Ave, Chicago, IL 60638. The listed phone number is (773) 671-1520.

What is Mireya Gamboa's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Developmental Disabilities, with taxonomy code 261QD1600X.

When was this NPI record last updated?

The NPPES record for Mireya Gamboa was last updated on May 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.