MEDICARE: S.GUTIERREZ,III,MD SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center		IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	209035	OTHER	IL	MEDICARE GRP. ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1164522769	OTHER	IL	NPI
2	01634265	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1710175880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S.GUTIERREZ,III,MD SC

Provider Business Mailing Address
First Line	:	2655 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1643
Country	:	US
Telephone Number	:	773-489-0133
Fax Number	:	773-862-6380

Provider Business Practice Location Address
First Line	:	2655 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1643
Country	:	US
Telephone Number	:	773-489-0133
Fax Number	:	773-862-6380

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SALVADOR RODOLFO GUTIERREZ III
Credential	:	M.D.
Telephone Number	:	773-489-0133

Provider Enumeration Date	:	10/14/2007
Last Update Date	:	10/25/2007

Similar Medicare Providers

1912960931 — DR. WILLIAM W. LI D.D.S.
Practice Location Address:

2655 N MILWAUKEE AVE
CHICAGO, IL
60647-1643

Practice Phone: 773-486-1264
Practice Fax: 773-486-9758

1164522769 — MR. SALVADOR RODOLFO GUTIERREZ III M.D.
Practice Location Address:

2655 N MILWAUKEE AVE
CHICAGO, IL
60647-1643

Practice Phone: 773-489-0133
Practice Fax:

1497809982 — APRIL DESIREE FERNANDO PH.D
Practice Location Address:

1643 N ROCKWELL ST # 1
CHICAGO, IL
60647-5217

Practice Phone: 510-875-5552
Practice Fax:

1386650885 — TAREK EL-SHIKH PT, DPT
Practice Location Address:

5764 S ARCHER AVE
CHICAGO, IL
60638-1643

Practice Phone: 773-284-0888
Practice Fax: 773-284-0880

1811905680 — ASHRAF TEBRY PT
Practice Location Address:

5764 S ARCHER AVE
CHICAGO, IL
60638-1643

Practice Phone: 773-284-0888
Practice Fax: 773-284-0880

1205907599 — IMAD BAHRANI DDS
Practice Location Address:

4254 N MILWAUKEE AVE
CHICAGO, IL
60641-1643

Practice Phone: 773-282-7906
Practice Fax: 773-427-2740

Directions to “S.GUTIERREZ,III,MD SC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.