Gunderson, Holly L
Gunderson, Holly L is an individual health care provider with primary practice located at 330 Madison St Suite 104, Joliet IL 60435-6565. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Gunderson, Holly L can be contacted via phone (815) 725-3440.Contact Information
Primary practice address
330 Madison St Suite 104
Joliet IL 60435-6565
Phone: (815) 725-3440
Fax: (815) 725-7209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036062769 | Illinois |
Profile Details
| NPI number | 1891737557 |
|---|---|
| LBN Legal business name | Gunderson, Holly L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2006 |
| Last updated | Jun 23rd, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891737557 | NPPES |
| Illinois | MEDICAID | 036062769 |
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