MEDICARE: JESSE KURTH PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		IL

General Provider Information

NPI Number	:	1720966310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE KURTH PA

Provider Business Mailing Address
First Line	:	2850 S WABASH AVE STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-2491
Country	:	US
Telephone Number	:	312-842-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 S WABASH AVE STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-2491
Country	:	US
Telephone Number	:	312-842-4600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	01/08/2026

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Directions to “ JESSE KURTH PA” Practice Location

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