JENNIFER D GUTSHALL (NPI# 1073524328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073524328 |
| Entity Type | Individual |
| Full Name | JENNIFER D GUTSHALL |
| Other Name | JENNIFER D JUDD |
| Credential | P.A. |
| Practice Address |
215 E 1st St Ste 215 Dixon IL 61021-3166 |
| Practice Telephone | 8152855422 |
| Practice Fax Number | 8152855426 |
| Mailing Telephone | 8152855422 |
| Mailing Fax Number | 8152855426 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2011-01-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085002531 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE | 085002531 | 01 |
| Street Address |
215 E 1ST ST STE 215 |
| City | DIXON |
| State | IL |
| Zip Code | 61021-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578531018 | Shirley J Stone | Obstetrics & Gynecology | 215 E 1st St Ste 215, Dixon, IL 61021 | 2006-03-10 |
| 1083189823 | Courtney M Duffy | Midwife | 215 E 1st St Ste 215, Dixon, IL 61021-3166 | 2018-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235182965 | Teresa Louise Franzen | Physician Assistant | 405 Davenport St, Dixon, IA 52745-0087 | 2006-05-17 |
| 1134440555 | Rachel Marie Deets | Physician Assistant | 1321 N Galena Ave, Dixon, IL 61021-1009 | 2010-06-21 |
| 1730157470 | Kathryn M Zeman | Physician Assistant | 102 S Hennepin Ave, Dixon, IL 61021-3083 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.