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NPI Code Detail

MEDICARE: DR. STEVEN KOURIS DO

MEDICARE: DR. STEVEN KOURIS DO
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
12084P0800XPsychiatry PhysicianIL

General Provider Information

NPI Number : 1154306389
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN KOURIS DO
Provider Business Mailing Address
First Line : 1601 PARKVIEW AVE
Second Line : CREDENTIALING S200
City : ROCKFORD
State : IL
Zip : 61107-1822
Country : US
Telephone Number : 815-395-5851
Fax Number : 815-395-5644
Provider Business Practice Location Address
First Line : 1601 PARKVIEW AVE
Second Line : UNIVERSITY PSYCHIATRIC SERVICES
City : ROCKFORD
State : IL
Zip : 61107-1822
Country : US
Telephone Number : 815-395-5870
Fax Number : 815-395-5644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 10/08/2007

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