Individual
JEFFREY DAVID GURTIZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4282 E ROCKTON RD, ROSCOE, IL 61073
(779) 696-9000
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
(779) 696-7342
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-136236
IL
207Q00000X
Family Medicine Physician
OT014384
PA
Other
Enumeration date
06/30/2011
Last updated
02/19/2021
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