Paul Andrew Gutowski

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13846 Issued in IL

Practice address

939 Galena Square Dr
Galena, IL 61036-1355

Phone

(815) 777-1300

Fax

(815) 777-1308

NPI assigned

May 28, 2020

Last updated

May 28, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1609499318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 CUMBERLAND ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611034146",
            "telephone_number": "815-978-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 GALENA SQUARE DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610361355",
            "telephone_number": "815-777-1300",
            "fax_number": "815-777-1308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2929 N Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611033199",
            "country_code": "US",
            "telephone_number": "815-915-4055",
            "fax_number": "815-915-4055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTOWSKI",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "13846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Galena, IL
• Providers in Galena, IL by specialty
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; 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.