Individual
JENNIFER D GUTSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
215 E 1ST ST STE 215, DIXON, IL 61021-3166
(815) 285-5422
(815) 285-5426
Mailing address
215 E 1ST ST STE 215, DIXON, IL 61021-3166
(815) 285-5422
(815) 285-5426
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085002531
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085002531
LICENSE
IL
Enumeration date
08/11/2006
Last updated
01/27/2011
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