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General NPI Number Information
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NPI Number | 1851132385
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Entity Type | Individual
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Provider Name | NATALIE MARIE KIERUZEL MD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 1740 W TAYLOR ST
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City | CHICAGO
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State | IL
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Zip | 60612-7232
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Country | US
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Telephone | 866-600-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 5130 SHADOW CREEK DR UNIT 9
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City | OAK FOREST
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State | IL
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Zip | 60452-3882
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Country | US
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Telephone | 708-407-1699
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 125084225
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License Number State | IL
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