Gustafson, Mary Jean

Gustafson, Mary Jean is an individual health care provider with primary practice located at 2123 Wesley Ave , Evanston IL 60201. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Nursing Service Providers / Registered Nurse. Dietary & Nutritional Service Providers / Nutritionist is her primary health care specialty. Gustafson, Mary Jean can be contacted via phone (773) 593-7379.

Contact Information

Primary practice address
2123 Wesley Ave Evanston IL 60201
Phone: (773) 593-7379
Fax: (847) 328-7494
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X
Nursing Service Providers / Registered Nurse 163W00000X Illinois

Profile Details

NPI number 1851594709
LBN Legal business name Gustafson, Mary Jean
Credentials Registered Nurse Certified (RNC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2007
Last updated Jul 8th, 2007 - about 18 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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