Individual
MRS. DEBORAH GORTOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
144 NORTH CT, DIXON, IL 61021-1224
(815) 285-5437
(815) 285-8928
Mailing address
144 NORTH CT, DIXON, IL 61021-1224
(815) 285-5347
(815) 285-8928
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209001773
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209001773
STATE LICENSE
IL
05
—
334563199001
—
IL
Enumeration date
12/09/2005
Last updated
09/07/2018
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