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Contact Information

KARL R GUNDERSEN, MD
2120 MADISON AVE
STE 405
GRANITE CITY, IL62040
 Phone: 618-876-0653
 Fax: 618-876-0654
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for KARL R GUNDERSEN · (Male)

NPI Number 1548362775
Status Active
Credentials MD
Entity Individual
Enumeration date 09/01/2006
Last updated 08/14/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036105102
  • IL Medicaid 036105102
  • MO Other 205739907 MEDICAID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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