Individual
DR. JOHN GREGORY SELGESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
403 E 1ST ST, DIXON, IL 61021
(815) 288-5531
Mailing address
102 S HENNEPIN AVE, DIXON, IL 61021-3083
(815) 288-7711
(815) 285-8922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-057471
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-057471
—
IL
Enumeration date
03/09/2006
Last updated
08/23/2018
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