Jessica Kandis Gutierrez, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209020490 Issued in IL

Practice address

1106 N Larkin Ave Lowr Level
Joliet, IL 60435-3455

Phone

(815) 685-4665

Fax

(630) 566-3322

NPI assigned

Nov 19, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1245876846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N LARKIN AVE LOWR LEVEL",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353455",
            "telephone_number": "815-685-4665",
            "fax_number": "630-566-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N LARKIN AVE LOWR LEVEL",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353455",
            "telephone_number": "815-685-4665",
            "fax_number": "630-566-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JESSICA",
        "middle_name": "KANDIS",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RiseAndThriveHealthcare.com",
            "affiliation": "N",
            "endpointDescription": "Healthcare Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1106 N Larkin Ave Lowr Level",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604353455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Atul N Gupta, MD
• Samir K Gupta, M.D.
• Aaron Gurfinchel, MD
• Ellen J Gustafson, MD
• Daniel Gutierrez, M.D.
• Susan Gwodz, FNP
• Amy L Haake, PT
• Jennifer L. Haas, APN
• Jamie Lynn Haberkorn
• Emma Hafner

• Family Nurse Practitioner in Joliet, IL
• Providers in Joliet, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.