| Doctor Name: | JENNIFER D GUTSHALL |
| NPI Number: | 1073524328 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A. |
| License Number: | 085002531 |
| Business Practice Address: | 215 E 1st St Ste 215 Dixon, IL - 610213166 |
| Business Phone Number: | 8152855422 |
| Business Fax Number: | 8152855426 |
| Mailing Address: | 215 E 1st St Ste 215, DIXON |
| State: | IL |
| Postal Code: | 610213166 |
| Phone Number: | 8152855422 |
| Fax Number: | 8152855426 |
| NPI Enumeration Date: | 08/11/2006 |
| NPI Last Update Date: | 01/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 085002531 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |