Ismael Gutierrez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036150102 Issued in IL

Practice address

17495 La Grange Rd
Tinley Park, IL 60487-7581

Phone

(708) 857-5800

Fax

(708) 857-5805

NPI assigned

Jun 1, 2016

Last updated

Feb 16, 2024By 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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Dupage Medical Group LTD

  dba DuPage Medical Group

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1952759854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17495 LA GRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877581",
            "telephone_number": "708-857-5800",
            "fax_number": "708-857-5805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6084 W Archer Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60638",
            "country_code": "US",
            "telephone_number": "773-355-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "ISMAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-01",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036150102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ismael.gutierrez.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "6084 W Archer Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "igutierrez265668@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17495 La Grange Rd",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604877581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Gruenke, DPT
• Nicole Grzybowski
• Gilbert Troy Guajardo, DMD
• Melissa Ann Gunderson
• Lillie Gurtisen, RN BSN
• Vincent David Gutierrez, P.T.
• Alyssa Guzman, RBT
• H14 Limited Liability Company (H14 Co.)
• Aida Haddad, OD
• Janelle Kala Hadley, MD, MPH

• Family Medicine Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.