Basic Information
| Provider Information | |||||||||
| NPI: | 1861432452 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELEON GOMEZ | ||||||||
| FirstName: | REGINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 W CENTRAL RD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600052349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476188400 | ||||||||
| FaxNumber: | 8476188409 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 W. CENTRAL ROAD | ||||||||
| Address2: | NORTHWEST COMMUNITY HOSPITAL | ||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476181000 | ||||||||
| FaxNumber: | 8476188409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 04/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 036106468 | IL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 036106468 | 01 | IL | STATE LICENSE | OTHER |