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Individual

DR. MARLA KUSHNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2437 N SOUTHPORT AVE, CHICAGO, IL 60614-2060
(773) 244-9600
(773) 248-2348
Mailing address
PO BOX 14730, CHICAGO, IL 60614-8523
(773) 244-9600
(833) 262-4857

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036075717
IL
207Q00000X
Family Medicine Physician
03675717
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036075717
IL
Enumeration date
05/11/2006
Last updated
12/17/2021
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