Provider Demographics
NPI:1457872400
Name:GOSTOMSKI, APRILEE DAWN VELEZ (MD)
Entity Type:Individual
Prefix:
First Name:APRILEE
Middle Name:DAWN VELEZ
Last Name:GOSTOMSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:APRILEE
Other - Middle Name:
Other - Last Name:VELEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:351 DELNOR DR STE 204
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4226
Mailing Address - Country:US
Mailing Address - Phone:630-653-4240
Mailing Address - Fax:630-938-9190
Practice Address - Street 1:351 DELNOR DR STE 204
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4226
Practice Address - Country:US
Practice Address - Phone:630-653-4240
Practice Address - Fax:630-938-9190
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036157060207VX0000X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTRN25577Medicaid