MEDICARE: CHRISTOPHER KUJAWSKI

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	171M00000X	Case Manager/Care Coordinator
2	171W00000X	Contractor

General Provider Information

NPI Number	:	1669827754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER KUJAWSKI

Provider Business Mailing Address
First Line	:	1017 W WASHINGTON BLVD
Second Line	:	SUITE 2J
City	:	CHICAGO
State	:	IL
Zip	:	60607-2119
Country	:	US
Telephone Number	:	866-414-3034
Fax Number	:	800-430-2202

Provider Business Practice Location Address
First Line	:	1017 W WASHINGTON BLVD
Second Line	:	SUITE 2J
City	:	CHICAGO
State	:	IL
Zip	:	60607-2119
Country	:	US
Telephone Number	:	866-414-3034
Fax Number	:	800-430-2202

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

Provider Enumeration Date	:	04/26/2016
Last Update Date	:	04/26/2016

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