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General NPI Number Information
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NPI Number | 1902877129
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Entity Type | Individual
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Provider Name | BORIS GUREVICH M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 3400 DUNDEE RD STE 230
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City | NORTHBROOK
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State | IL
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Zip | 60062-2334
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Country | US
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Telephone | 847-849-1523
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Fax | 847-890-6145
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Provider Business Mailing Address
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Address Line | 566 LINCOLN AVE UNIT 2E
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City | WINNETKA
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State | IL
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Zip | 60093-2354
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Country | US
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Telephone | 847-226-5503
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036062524
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License Number State | IL
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