Provider Demographics
NPI:1679920177
Name:GUTIERREZ-VILLAFUERTE, YVONNE ASMIDIA (MS)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:ASMIDIA
Last Name:GUTIERREZ-VILLAFUERTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 S ROCKWELL ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632-1430
Mailing Address - Country:US
Mailing Address - Phone:773-403-0357
Mailing Address - Fax:
Practice Address - Street 1:4921 S ROCKWELL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-1430
Practice Address - Country:US
Practice Address - Phone:773-403-0357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist