Individual
DR. JILL L GORSUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, MPH
Contact information
Practice address
42 N SAINT JOSEPH AVE, SUITE 100, NILES, MI 49120-2203
(269) 684-6696
(269) 684-5286
Mailing address
42 N SAINT JOSEPH AVE, SUITE 100, NILES, MI 49120-2203
(269) 684-6696
(269) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
006332
AZ
208600000X
Surgery Physician
Primary
5101018409
MI
208600000X
Surgery Physician
L1593656
MI
Other
Enumeration date
08/17/2009
Last updated
02/03/2017
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