Provider Demographics
NPI:1255754545
Name:DAWNA GUTZMANN, M.D., LLC
Entity type:Organization
Organization Name:DAWNA GUTZMANN, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTZMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-488-9599
Mailing Address - Street 1:5225 OLD ORCHARD RD STE 36
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1027
Mailing Address - Country:US
Mailing Address - Phone:312-488-9959
Mailing Address - Fax:
Practice Address - Street 1:5225 OLD ORCHARD RD STE 36
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1027
Practice Address - Country:US
Practice Address - Phone:312-488-9599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360755762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty