Jennifer L Gilstrap, COTA/L
Individual provider Active NPI Specialist · Lincoln, IL
NPI 1700049640 · NPPES record last updated Jul 9, 2008
Key facts
- NPI
- 1700049640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 057.002857 (IL)
- Practice address
- 1507 7TH St
Lincoln, IL 62656-2216 - Phone
- (217) 732-4826
- Fax
- (217) 732-8041
- NPI assigned
- Jul 9, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057.002857 | IL | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 057.002857 | IL | Yes |
Addresses
Primary practice location
1507 7TH St
Lincoln, IL 62656-2216
Mailing address
1507 7TH St
Lincoln, IL 62656-2216
Phone (217) 732-4826
Other providers in Lincoln, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.