S.Gutierrez,III,MD SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

S.GUTIERREZ,III,MD SC

Practice address

2655 N Milwaukee Ave
Chicago, IL 60647-1643

Phone

(773) 489-0133

Fax

(773) 862-6380

NPI assigned

Oct 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Salvador Rodolfo Gutierrez III, M.D.

Title

President

Phone

(773) 489-0133

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1192320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1710175880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471643",
            "telephone_number": "773-489-0133",
            "fax_number": "773-862-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471643",
            "telephone_number": "773-489-0133",
            "fax_number": "773-862-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.GUTIERREZ,III,MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-14",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "SALVADOR",
        "authorized_official_middle_name": "RODOLFO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-489-0133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164522769",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01634265",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP. ID",
            "identifier": "209035",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.