Provider Demographics
NPI:1447713201
Name:BRILLIANT WOMEN CARE, INC
Entity type:Organization
Organization Name:BRILLIANT WOMEN CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMAA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-935-2937
Mailing Address - Street 1:7613 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-1113
Mailing Address - Country:US
Mailing Address - Phone:630-935-2937
Mailing Address - Fax:
Practice Address - Street 1:4121 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2264
Practice Address - Country:US
Practice Address - Phone:630-935-2937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty