Individual
MRS. ELIZABETH GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7433 N CLARK ST, CHICAGO, IL 60626-1619
(773) 338-8778
Mailing address
7433 N CLARK ST, CHICAGO, IL 60626-1619
(773) 338-8778
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056004727
IL
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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