Healthcare Provider Details

I. General information

NPI: 1235337031
Provider Name (Legal Business Name): MONICA B KURZAWA O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 W HIGGINS RD STE 102
HOFFMAN ESTATES IL
60169-4024
US

IV. Provider business mailing address

1220 W HIGGINS RD STE 102
HOFFMAN ESTATES IL
60169-4024
US

V. Phone/Fax

Practice location:
  • Phone: 847-755-9393
  • Fax:
Mailing address:
  • Phone: 847-755-9393
  • Fax: 847-755-1560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046009954
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: