1447382783 NPI number — DR. MICHAEL STAN KUZLIK MD

Table of content: DR. MICHAEL STAN KUZLIK MD (NPI 1447382783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447382783 NPI number — DR. MICHAEL STAN KUZLIK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUZLIK
Provider First Name:
MICHAEL
Provider Middle Name:
STAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447382783
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14501 S 88TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLAND PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60462-2752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-349-0938
Provider Business Mailing Address Fax Number:
815-729-6522

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RT 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOLIET
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-729-6256
Provider Business Practice Location Address Fax Number:
815-729-6522
Provider Enumeration Date:
03/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com