Individual
MS. SUSAN KELLY GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
3707 WEST LAKE AVE., SUITE #200, GLENVIEW, IL 60026
(847) 998-1188
Mailing address
5879 N MEDINA AVE, CHICAGO, IL 60646-5303
(773) 467-8205
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160001127
IL
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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