Jaclyn Gutierrez, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-12623

Practice address

4801 W Peterson Ave
Suite 512
Chicago, IL 60646-5713

Phone

(773) 539-7099

Fax

(773) 539-8099

NPI assigned

Nov 15, 2007

Last updated

Jan 31, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BGF Childrens Therapy, LLC

  • Behavior Analyst
  • Chicago, IL
  • NPI 1528579778
  NPD (past)
• Bradley G Frieswyk BGF Performance Systems

  dba BGF Performance Systems

  • Behavior Analyst
  • Chicago, IL
  • NPI 1477852887
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1215118567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4054 N PAULINA ST APT 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132574",
            "telephone_number": "440-452-8046",
            "fax_number": "773-539-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "SUITE 512",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465713",
            "telephone_number": "773-539-7099",
            "fax_number": "773-539-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JACLYN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-12-12623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08258",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esmeralda Gutierrez
• Felisa Gutierrez, LCSW
• Francisco Alberto Gutierrez, MD
• Francisco J Gutierrez, MA, LCPC, CADC
• Ivone Gutierrez
• Joanne Yum Gutierrez, OTR/L
• Jorge Alejandro Gutierrez III, MD
• Juliet Marie Gutierrez
• Karin Lorene Gutierrez, LPC
• Kassandra Gutierrez, RBT

• Behavior Analyst in Chicago, IL
• Providers in Chicago, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.