Healthcare Provider Details

I. General information

NPI: 1225100712
Provider Name (Legal Business Name): JAY HURH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S MILWAUKEE AVENUE WEST TOWER, LL500
LIBERTYVILLE IL
60048
US

IV. Provider business mailing address

801 S MILWAUKEE AVENUE WEST TOWER, SUITE LL500
LIBERTYVILLE IL
60048
US

V. Phone/Fax

Practice location:
  • Phone: 847-279-0061
  • Fax: 847-279-0069
Mailing address:
  • Phone: 848-279-0061
  • Fax: 847-279-0069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036-129585
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: