Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Zachary R Gustavison, PA-C

Individual provider Physician Assistant · NPI 1316108970

Mr. Zachary R Gustavison, PA-C is a Physician Assistant in Herrin, Illinois. Qualified in 2008, 18 years ago. Practices with Deaconess Illinois Specialty Clinic, Inc, a 139-clinician group, works from 7 locations and accepts Medicare assignment. Licensed in Illinois and Michigan.

Years since qualifying
18
Licensed in
IL, MI
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

201 S 14th St
Herrin, IL 62948-3631
Phone: (618) 942-2171
Fax: (618) 351-4917
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (6)

  • 1 Saint Anthonys Way, Alton, IL 62002-4568 — (618) 465-2571
  • 405 W Jackson St, Carbondale, IL 62901-1462 — (618) 549-0721
  • 901 S Commercial St, Harrisburg, IL 62946-2640 — (618) 993-3817
  • 2808 Outer Dr, Marion, IL 62959-5207 — (618) 993-3817
  • 605 N 12th St, Mount Vernon, IL 62864-2857 — (586) 263-2601
  • 2 S Hospital Dr, Murphysboro, IL 62966-3333 — (618) 684-3156

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-003467 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 5601005286 (MI)

Record details

NPI number1316108970
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 17, 2008
Last updated in NPPESJuly 18, 2024
Certification dateJuly 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Deaconess Illinois Specialty Clinic, Inc. — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Herrin