Provider Demographics
NPI:1134253404
Name:NORDSTROM-HUTCHISON, KAREN J (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:J
Last Name:NORDSTROM-HUTCHISON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:HOPEDALE
Mailing Address - State:IL
Mailing Address - Zip Code:61747-0303
Mailing Address - Country:US
Mailing Address - Phone:309-449-3371
Mailing Address - Fax:309-449-0068
Practice Address - Street 1:124 NW MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPEDALE
Practice Address - State:IL
Practice Address - Zip Code:61747-7511
Practice Address - Country:US
Practice Address - Phone:309-449-3371
Practice Address - Fax:309-449-0068
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190179161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice