Provider Demographics
NPI:1922189604
Name:GUTIERREZ, PATRICIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8743 KELLS DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1793
Mailing Address - Country:US
Mailing Address - Phone:708-233-0109
Mailing Address - Fax:
Practice Address - Street 1:2545 S KING DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2441
Practice Address - Country:US
Practice Address - Phone:312-808-5585
Practice Address - Fax:312-808-5501
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist