Individual
DR. DUSTIN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 N SAINT CLAIR ST, 17TH FLOOR, CHICAGO, IL 60611-5975
(312) 695-5620
Mailing address
676 N SAINT CLAIR ST, SUITE 1400, CHICAGO, IL 60611-2927
(312) 926-4939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036129287
IL
207RG0100X
Gastroenterology Physician
Primary
036129287
IL
Other
Enumeration date
09/04/2009
Last updated
06/01/2016
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