Basic Information
Provider Information
NPI: 1245314004
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUTIERREZ
FirstName: APRIL
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 6013
Address2:  
City: ST CHARLES
State: IL
PostalCode: 601746013
CountryCode: US
TelephoneNumber: 6304669240
FaxNumber: 6302622643
Practice Location
Address1: 2700 KESLINGER RD
Address2: SUITE C
City: GENEVA
State: IL
PostalCode: 601344645
CountryCode: US
TelephoneNumber: 6302622633
FaxNumber: 6302622643
Other Information
ProviderEnumerationDate: 10/25/2006
LastUpdateDate: 01/10/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X070015375ILY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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