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NPI Code Detail

MEDICARE: SHANNON ROSE KURIAN

MEDICARE:   SHANNON ROSE KURIAN
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
1207V00000XObstetrics & Gynecology Physician036175756IL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1275119620
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON ROSE KURIAN
Provider Business Mailing Address
First Line : 2000 OGDEN AVE STE P050
Second Line :
City : AURORA
State : IL
Zip : 60504-5893
Country : US
Telephone Number : 630-499-2404
Fax Number : 630-499-4750
Provider Business Practice Location Address
First Line : 2020 OGDEN AVE STE 225
Second Line :
City : AURORA
State : IL
Zip : 60504-6193
Country : US
Telephone Number : 630-978-4800
Fax Number : 630-978-6791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 09/25/2025

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Directions to “ SHANNON ROSE KURIAN ” Practice Location

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