Organization
JORGE ALBERTO KURGANOFF MD AND ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE A KURGANOFF M.D. (PRESIDENT)
(847) 924-3175
Entity
Organization
Contact information
Practice address
800 AUSTIN ST, EVANSTON, IL 60202-3439
(847) 733-7370
Mailing address
PO BOX 1386, EVANSTON, IL 60204-1386
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036083831
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083831
—
IL
01
—
1623073
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/10/2007
Last updated
10/05/2010
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