Individual
BERTHA PATRICIA GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5647 W ADDISON ST, CHICAGO, IL 60634-4403
(773) 736-1830
(773) 736-1840
Mailing address
1431 N WESTERN AVE, SUITE 401, CHICAGO, IL 60622-1797
(312) 699-5841
(312) 491-5485
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036123675
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123675
—
IL
Enumeration date
03/31/2008
Last updated
12/07/2015
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