Individual
MRS. MICHELLE R GAUDIUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2300 N CHILDRENS PLZ, CHICAGO, IL 60614-3363
(773) 327-3931
Mailing address
2300 N CHILDRENS PLZ, CHICAGO, IL 60614-3363
(773) 327-3931
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.007811
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.007811
STATE LICENSE NUMBER
IL
Enumeration date
07/30/2010
Last updated
07/30/2010
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