Individual
ANDREW A GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
251 E HURON ST STE 16-738, CHICAGO, IL 60611-3055
(312) 926-5924
(312) 926-6134
Mailing address
251 E HURON ST STE 16-738, CHICAGO, IL 60611-3055
(312) 926-5924
(312) 926-6134
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1568099885
IL
208M00000X
Hospitalist Physician
Primary
036164504
IL
Other
Enumeration date
03/25/2020
Last updated
10/19/2023
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