Provider Demographics
NPI:1205985678
Name:GUTMANN, MIRIAM BETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:BETTE
Last Name:GUTMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4711 GOLF RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1224
Mailing Address - Country:US
Mailing Address - Phone:312-321-6047
Mailing Address - Fax:847-675-7173
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:SUITE 700
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1224
Practice Address - Country:US
Practice Address - Phone:312-321-6047
Practice Address - Fax:847-675-7173
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry