Provider Demographics
NPI:1073983821
Name:MERCEDES GUTIERREZ DBA CONNECTING DOTS
Entity Type:Organization
Organization Name:MERCEDES GUTIERREZ DBA CONNECTING DOTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERPRETER
Authorized Official - Prefix:
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-742-7023
Mailing Address - Street 1:6349 S LONG AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-5616
Mailing Address - Country:US
Mailing Address - Phone:773-742-7023
Mailing Address - Fax:
Practice Address - Street 1:6349 S LONG AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-5616
Practice Address - Country:US
Practice Address - Phone:773-742-7023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency