MEDICARE: MS. SUSAN K KURTENBACH APN

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	363LF0000X	Family Nurse Practitioner	309-000686	IL

General Provider Information

NPI Number	:	1538173240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN K KURTENBACH APN

Provider Business Mailing Address
First Line	:	1023 LYMAN AVE
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60304-2225
Country	:	US
Telephone Number	:	708-217-7567
Fax Number	:	773-521-9543

Provider Business Practice Location Address
First Line	:	4015 N ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2593
Country	:	US
Telephone Number	:	773-404-0447
Fax Number	:	773-404-2484

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	09/11/2025

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