Individual
DR. THOMAS EARL GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
96 W NORTHWEST HWY, PALATINE, IL 60067-3571
(847) 358-7722
(847) 934-0661
Mailing address
96 W NORTHWEST HWY, PALATINE, IL 60067-3571
(847) 358-7722
(847) 934-0661
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008241
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008241
—
IL
Enumeration date
01/24/2006
Last updated
03/13/2020
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