Individual
DR. GEORGE J KOURIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 W HARRISON ST, 212, CHICAGO, IL 60612-4861
(312) 432-2850
(312) 563-2545
Mailing address
1611 W HARRISON ST., 212, CHICAGO, IL 60612-3841
(312) 432-2850
(312) 563-2545
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036-108015
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108015
—
IL
01
—
1634518
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
01/15/2007
Last updated
01/18/2012
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