Healthcare Provider Details

I. General information

NPI: 1992818991
Provider Name (Legal Business Name): MATTHEW J. KUHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CARPENTER ST DEPARTMENT OF RADIOLOGY
SPRINGFIELD IL
62702-5324
US

IV. Provider business mailing address

611 N 6TH ST
SPRINGFIELD IL
62702-5327
US

V. Phone/Fax

Practice location:
  • Phone: 217-544-6464
  • Fax: 217-525-5671
Mailing address:
  • Phone: 217-544-2149
  • Fax: 217-544-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: