Provider Demographics
NPI:1720164726
Name:SCHUTTER, GERALD ALLEN (MSED)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:ALLEN
Last Name:SCHUTTER
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:MR
Other - First Name:JERRY
Other - Middle Name:A
Other - Last Name:SCHUTTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS ED
Mailing Address - Street 1:531 CLARENCE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1301
Mailing Address - Country:US
Mailing Address - Phone:708-386-7915
Mailing Address - Fax:
Practice Address - Street 1:5TH AVE. & ROOSEVELT ROAD
Practice Address - Street 2:BUILDING 113
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-5000
Practice Address - Country:US
Practice Address - Phone:708-202-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind