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NPI Code Detail

MEDICARE: BRIAN KURTZ DO

MEDICARE: BRIAN KURTZ 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
1207R00000XInternal Medicine Physician036.135878IL

General Provider Information

NPI Number : 1831469253
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN KURTZ DO
Provider Business Mailing Address
First Line : 213 N RACINE AVE
Second Line : SUITE 100
City : CHICAGO
State : IL
Zip : 60607-1644
Country : US
Telephone Number : 312-733-9730
Fax Number : 773-866-8014
Provider Business Practice Location Address
First Line : 4318 S STATE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60609-3701
Country : US
Telephone Number : 773-285-9304
Fax Number : 773-564-3501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2012
Last Update Date : 10/15/2015

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Directions to “ BRIAN KURTZ DO” Practice Location

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