Healthcare Provider Details

I. General information

NPI: 1184538449
Provider Name (Legal Business Name): ANDREW KURTZMAN DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 FORT JESSE RD
NORMAL IL
61761-6192
US

IV. Provider business mailing address

1537 FORT JESSE RD
NORMAL IL
61761-6192
US

V. Phone/Fax

Practice location:
  • Phone: 309-830-6454
  • Fax:
Mailing address:
  • Phone: 309-830-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number090014571
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: