Karin Gustafson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-083067 Issued in IL

Practice address

2020 Ogden Ave
Suite 120
Aurora, IL 60504-5894

Phone

(630) 375-2852

Fax

(630) 375-2838

NPI assigned

Sep 22, 2005

Last updated

Jul 7, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rush-Copley Medical Group, NFP

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1093075848
  Medicare reassignment NPD
• Rush-Copley Medical Group

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Aurora, IL
  • NPI 1376894501
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1336135573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 WATERFORD DRIVE",
            "address_2": "SUITE 230",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60504",
            "telephone_number": "630-499-2404",
            "fax_number": "630-499-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 OGDEN AVE",
            "address_2": "SUITE 120",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045894",
            "telephone_number": "630-375-2852",
            "fax_number": "630-375-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "KARIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-083067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos U Guillen
• Ginger T. Guinther, CRNA
• Shaiyna Kaur Gulati
• Thomas Anthony Gulino, APN, RN, ONC
• Madeline Gurchiek
• Gustavo Ricardo Sanchez Vargas MD SC
• Ambrielle Rose Guthrie
• Katherine A Gutierrez, LCSW, CADC
• Nicole Elizabeth Gutierrez
• Karen Oribello Gutsmiedl, APN, FNP-BC

• Family Medicine Physician in Aurora, IL
• Providers in Aurora, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.