Search › Illinois › 183500000X
Jennifer Gautam
NPI 1306433750 · on the registry since 2020
Practice
- Address
- 5205 N Broadway St
Chicago, IL 60640 - Phone
- (773) 275-5641
- Fax
- (773) 275-7324
- Organisation at this address
- Highland Park Cvs Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-12-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois