Gutierrez, Mary Lou

Gutierrez, Mary Lou is an individual health care provider with primary practice located at 4100 Healthway Dr , Aurora IL 60504-4163. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Gutierrez, Mary Lou can be contacted via phone (630) 851-3105.

Contact Information

Primary practice address
4100 Healthway Dr Aurora IL 60504-4163
Phone: (630) 851-3105
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036107891 Illinois

Profile Details

NPI number 1992913412
LBN Legal business name Gutierrez, Mary Lou
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2007
Last updated Nov 6th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992913412 NPPES
Illinois MEDICAID 036107891

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