Ilitch Diaz Gutierrez, MD | |
1655 Beam Ave Ste 302, Maplewood, MN 55109-1477 | |
(651) 227-6351 | |
Not Available |
Full Name | Ilitch Diaz Gutierrez |
---|---|
Gender | Male |
Speciality | Thoracic Surgery |
Experience | 17 Years |
Location | 1655 Beam Ave Ste 302, Maplewood, Minnesota |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629209366 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | RS2009-0378 (New Mexico) | Secondary |
208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 63088 (Minnesota) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
University Of Minnesota Medical Center, Fairview | Minneapolis, MN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Fairview Express Care | 3375645179 | 1537 |
University Of Minnesota Health Clinics And Surgery Center Inc | 9133423304 | 483 |
Entity Name | University Of Minnesota Physicians |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477598118 PECOS PAC ID: 9830001189 Enrollment ID: O20031104000532 |
Entity Name | Fairview Health Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
Entity Name | Fairview Clinics |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516 |
Entity Name | Range Regional Health Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669569265 PECOS PAC ID: 8022920024 Enrollment ID: O20031110000095 |
Entity Name | Healtheast Medical Research Institute |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639125503 PECOS PAC ID: 3971407636 Enrollment ID: O20031124000507 |
Entity Name | Fairview Express Care |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
Entity Name | University Of Minnesota Health Clinics And Surgery Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053795187 PECOS PAC ID: 9133423304 Enrollment ID: O20160209000524 |
Mailing Address | Practice Location Address |
---|---|
Ilitch Diaz Gutierrez, MD 3144 Chowen Ave S, Apt 219b, Minneapolis, MN 55416-5398 Ph: (505) 818-7180 | Ilitch Diaz Gutierrez, MD 1655 Beam Ave Ste 302, Maplewood, MN 55109-1477 Ph: (651) 227-6351 |