Owens Gutierre, Miriam P
Owens Gutierre, Miriam P is an individual health care provider with primary practice located at 422 Tag Way , Crystal Lake IL 60014-6288. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Owens Gutierre, Miriam P can be contacted via phone (815) 444-6400.Contact Information
Primary practice address
422 Tag Way
Crystal Lake IL 60014-6288
Phone: (815) 444-6400
Fax: (815) 444-6816
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | Illinois |
Profile Details
| NPI number | 1871618801 |
|---|---|
| LBN Legal business name | Owens Gutierre, Miriam P |
| Credentials | LCPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871618801 | NPPES |
| Illinois | Other | 3636144473 | EIN |
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