Healthcare Provider Details

I. General information

NPI: 1801709910
Provider Name (Legal Business Name): ALYSSA GUTIERREZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W WARNER AVE STE 200
CHICAGO IL
60613-1891
US

IV. Provider business mailing address

1801 W WARNER AVE STE 200
CHICAGO IL
60613-1891
US

V. Phone/Fax

Practice location:
  • Phone: 773-217-0540
  • Fax: 773-304-3567
Mailing address:
  • Phone: 773-217-0540
  • Fax: 773-304-3567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178022108
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: