Individual
SAMANTHA J KURNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5647 W ADDISON ST, CHICAGO, IL 60634-4403
(773) 736-1830
(773) 736-1840
Mailing address
2232 N CLYBOURN AVE FL 3, CHICAGO, IL 60614-3193
(312) 633-5841
(773) 269-5500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-006266
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
08/11/2017
Last updated
01/27/2022
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