Search › Illinois › 363A00000X
Zachary Gustavison, PA-C
NPI 1316108970 · on the registry since 2008
Practice
- Address
- 201 S 14th St
Herrin, IL 62948 - Phone
- (618) 942-2171
- Fax
- (618) 351-4917
- Organisation at this address
- Herrin Hospital Pharmacy
Southern Illinois Healthcare
Southern Illinois Healthcare
River2 Emergency Physicians Llp
Southern Illinois Hospital ServicesInferred from a shared address, not stated in the registry. - Clinicians at this address
- 92
Additional practice sites
- 605 N 12th St, Mount Vernon, IL
- 1 Saint Anthonys Way, Alton, IL
- 2808 Outer Dr, Marion, IL
- 901 S Commercial St, Harrisburg, IL
- 405 W Jackson St, Carbondale, IL
- 2 S Hospital Dr, Murphysboro, IL
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
- Licence states on file
- MI, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-07-18
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