Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016003379 | IL |
Y | 222Z00000X | Podiatrist | 016003379 | IL |
NPI | 1053306076 |
---|---|
Provider Name | Dr. Curt S Krevitz |
First Address | Chicago, IL 60611-2987 |
Second Address | Chicago, IL 60611-2987 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 13/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016003379 | (05) | IL |
016003379 | BCBS (01) | IL |
1245580001 | DME NATIONAL GOVERNMENT SERVICES (01) | IL |
480019879 | RR MEDICARE (01) | IL |
K25691 | MEDICARE NSC (01) | IL |
K25691 | MEDICARE PTAN (01) | IL |
T37856 | (02) | IL |