Provider Demographics
NPI:1780802223
Name:GERALD G. GUTSELL, D.D.S., LTD.
Entity type:Organization
Organization Name:GERALD G. GUTSELL, D.D.S., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:GUTSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-763-0433
Mailing Address - Street 1:6801 W HIGGINS AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-2009
Mailing Address - Country:US
Mailing Address - Phone:773-763-0433
Mailing Address - Fax:
Practice Address - Street 1:6801 W HIGGINS AVE
Practice Address - Street 2:SUITE E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-2009
Practice Address - Country:US
Practice Address - Phone:773-763-0433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental