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Organization

JORGE KURGANOFF, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JORGE KURGANOFF M.D. (PRESIDENT)
(847) 733-7370
Entity
Organization

Contact information

Practice address
800 AUSTIN ST, SUITE 202 WEST TOWER, EVANSTON, IL 60202-3439
(847) 733-7370
(847) 733-7975
Mailing address
800 AUSTIN ST, SUITE 202 WEST TOWER, EVANSTON, IL 60202-3439
(847) 733-7370
(847) 733-7975

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01623073
BLUE SHIELD
IL
Enumeration date
12/22/2006
Last updated
08/22/2020
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