Healthcare Provider Details

I. General information

NPI: 1578097473
Provider Name (Legal Business Name): ANDREW KUHN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S MORGAN ST UNIT 513 C
CHICAGO IL
60607-3529
US

IV. Provider business mailing address

410 S MORGAN ST UNIT 513 C
CHICAGO IL
60607-3529
US

V. Phone/Fax

Practice location:
  • Phone: 312-683-6933
  • Fax:
Mailing address:
  • Phone: 312-683-6933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number57249
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number326830
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: