Individual
GLADYS OTITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6374 N LINCOLN AVE STE 201, CHICAGO, IL 60659-1219
(773) 539-4145
(773) 539-1207
Mailing address
6374 N LINCOLN AVE STE 201, CHICAGO, IL 60659-1219
(773) 539-4145
(773) 539-1207
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
209025801
IL
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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