Gustafson, Deanne Marie

Gustafson, Deanne Marie is an individual health care provider with primary practice located at 1301 W Cossitt Ave , La Grange IL 60525-2145. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Gustafson, Deanne Marie can be contacted via phone (708) 354-5730.

Contact Information

Primary practice address
1301 W Cossitt Ave La Grange IL 60525-2145
Phone: (708) 354-5730
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 1884039 Illinois

Profile Details

NPI number 1104423409
LBN Legal business name Gustafson, Deanne Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2020
Last updated Oct 8th, 2020 - about 5 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.

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