Provider Demographics
NPI:1659773455
Name:GUNTHER, JODI LYNN (RN, APN-CNS)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:GUNTHER
Suffix:
Gender:F
Credentials:RN, APN-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BIESTERFIELD RD STE 610
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3362
Mailing Address - Country:US
Mailing Address - Phone:847-981-3630
Mailing Address - Fax:847-981-3626
Practice Address - Street 1:800 BIESTERFIELD RD STE 610
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3362
Practice Address - Country:US
Practice Address - Phone:847-981-3630
Practice Address - Fax:847-981-3626
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.219519163W00000X
IL209.001594364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse