Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 019030707 | IL |
NPI | 1003266958 |
---|---|
Provider Name | Dr. Francesca Jessica Gattuso |
First Address | Chicago, IL 60612-2228 |
Second Address | Chicago, IL 60609-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2016 |
Last Update Date | 26/06/2019 |