MEDICARE: KEMAL KUCUK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	72984	WI
2	208M00000X	Hospitalist Physician	72984	WI
3	207R00000X	Internal Medicine Physician	036.164855	IL

General Provider Information

NPI Number	:	1053844142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEMAL KUCUK

Provider Business Mailing Address
First Line	:	1111 N MILWAUKEE AVE UNIT 262
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1659
Country	:	US
Telephone Number	:	706-506-6870
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 N MILWAUKEE AVE UNIT 262
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1659
Country	:	US
Telephone Number	:	706-506-6870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	11/11/2024

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Directions to “ KEMAL KUCUK ” Practice Location

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