Gustafson, Dawn M

Gustafson, Dawn M is an individual health care provider with primary practice located at 4412 S Pulaski Rd , Chicago IL 60632-4011. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Gustafson, Dawn M can be contacted via phone (773) 847-3123.

Contact Information

Primary practice address
4412 S Pulaski Rd Chicago IL 60632-4011
Phone: (773) 847-3123
Fax: (773) 847-3778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070016797 Illinois
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT38367 California

Profile Details

NPI number 1932353281
LBN Legal business name Gustafson, Dawn M
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2008
Last updated Nov 29th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932353281 NPPES
Illinois Other 1619980 BCBS OF IL

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