MEDICARE: GEORGE B KUZYCZ MD

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	036040958	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01077990	OTHER	IL	RAILROAD MEDICARE PTAN (INDIVIDUAL)
3	CA4748	OTHER	IL	RAILROAD MEDICARE PTAN (GROUP)
4	206147	OTHER		MEDICARE PTAN (GROUP)
5	T01703	OTHER		MEDICARE PTAN (INDIVIDUAL)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912973835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE B KUZYCZ MD

Provider Business Mailing Address
First Line	:	25 N. WINFIELD RD.
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1295
Country	:	US
Telephone Number	:	630-933-4480
Fax Number	:	630-933-2009

Provider Business Practice Location Address
First Line	:	25 N. WINFIELD RD.
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1295
Country	:	US
Telephone Number	:	630-933-4480
Fax Number	:	630-933-2009

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	11/29/2012

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Directions to “ GEORGE B KUZYCZ MD” Practice Location

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