Provider Demographics
NPI:1780048256
Name:UTTER, BRIGITTE FRETT
Entity type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:FRETT
Last Name:UTTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9933 WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1049
Mailing Address - Country:US
Mailing Address - Phone:847-663-8060
Mailing Address - Fax:847-663-1027
Practice Address - Street 1:9933 WOODS DR
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1049
Practice Address - Country:US
Practice Address - Phone:847-663-8060
Practice Address - Fax:847-663-1027
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036154217207N00000X
CODR.0062558207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology