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Contact Information

DANA GUSTAFSON, DPM
2160 S 1ST AVE
MAYWOOD, IL60153-3328
 Phone: 708-216-9000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for DANA GUSTAFSON · (Female)

NPI Number 1407352289
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 04/02/2018
Last updated 07/24/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 135.001016
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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