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1093026247

NPI Code Detail

MEDICARE: ANNA LAKOMA KUIKEN MD

MEDICARE: ANNA LAKOMA KUIKEN MD

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	208600000X	Surgery Physician	01086656A	IN
2	2086S0102X	Surgical Critical Care Physician	01086656A	IN
3	208600000X	Surgery Physician	BP10036863	TX
4	208600000X	Surgery Physician	036.143479	IL
5	2086X0206X	Surgical Oncology Physician	01086656A	IN

General Provider Information

NPI Number	:	1093026247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA LAKOMA KUIKEN MD

Provider Business Mailing Address
First Line	:	4309 W MEDICAL CENTER DR STE B202
Second Line	:
City	:	MCHENRY
State	:	IL
Zip	:	60050-8417
Country	:	US
Telephone Number	:	815-455-2752
Fax Number	:	815-455-2789

Provider Business Practice Location Address
First Line	:	4309 W MEDICAL CENTER DR STE B202
Second Line	:
City	:	MCHENRY
State	:	IL
Zip	:	60050-8417
Country	:	US
Telephone Number	:	815-455-2752
Fax Number	:	815-455-2789

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

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	10/29/2025

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Directions to “ ANNA LAKOMA KUIKEN MD” Practice Location

Language	Start Address	Practice Location

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