Elizabeth Gamboa

Clinical Social Worker · Urbana, IL

Individual Active NPI

NPI number 1104752906

Practice location

2210 Vawter St
Urbana, IL 61801-6944
Phone
(773) 507-9501

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NPI record

NPI
1104752906
Entity type
Individual (Type 1)
Enumeration date
June 19, 2026
Last updated
June 19, 2026
Certified
June 19, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 149017242 IL

About Elizabeth Gamboa

Elizabeth Gamboa is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 2210 Vawter St, Urbana, IL 61801-6944. The NPI number 1104752906 was assigned on June 19, 2026 and the record was last updated on June 19, 2026.

Elizabeth Gamboa lists a license in the registry: #149017242 (IL) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Elizabeth Gamboa?

The NPI number is 1104752906.

What is the phone number of Elizabeth Gamboa?

The phone number listed for the practice location is (773) 507-9501.

Where is Elizabeth Gamboa located?

2210 Vawter St, Urbana, IL 61801-6944.

What is the taxonomy code for Elizabeth Gamboa?

The primary taxonomy code is 1041C0700X – Clinical Social Worker.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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