Provider Demographics
NPI:1841733409
Name:GUTIERREZ, ADRIANA SILVIA (PT, MPT, DPT)
Entity type:Individual
Prefix:MS
First Name:ADRIANA
Middle Name:SILVIA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PT, MPT, DPT
Other - Prefix:MRS
Other - First Name:ADRIANA
Other - Middle Name:SILVIA
Other - Last Name:GUTIERREZ-SALVATORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:224 S OAK PARK AVE
Mailing Address - Street 2:APT 2A
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-3233
Mailing Address - Country:US
Mailing Address - Phone:708-915-9745
Mailing Address - Fax:
Practice Address - Street 1:928 JOLIET ST
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-3725
Practice Address - Country:US
Practice Address - Phone:630-231-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.008756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist