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General NPI Number Information
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NPI Number | 1851669618
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Entity Type | Organization
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Legal Business Name | DANIEL A GUTSTEIN, MD, LTD
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 8170 MCCORMICK BLVD STE 190
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City | SKOKIE
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State | IL
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Zip | 60076-2961
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Country | US
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Telephone | 847-626-4374
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Fax | 847-929-4266
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Provider Business Mailing Address
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Address Line | 8170 MCCORMICK BLVD STE 190
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City | SKOKIE
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State | IL
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Zip | 60076-2961
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Country | US
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Telephone | 847-626-4374
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Fax | 847-929-4266
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL A GUTSTEIN
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Credential | M.D.
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Telephone | 847-626-4374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036109673
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License Number State | IL
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