Individual
ETHAN GUTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
332 S MICHIGAN AVE STE 900, CHICAGO, IL 60604-4393
(855) 832-6727
Mailing address
12813 BRADFORD LN, PLAINFIELD, IL 60585-2245
(815) 210-7453
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-286606
IL
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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