Individual
KENNETH ALLEN KUZNETSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5645 W ADDISON ST, CHICAGO, IL 60634-4403
(773) 348-4640
(773) 794-4698
Mailing address
2253 N GENEVA TER, CHICAGO, IL 60614-3746
(773) 348-4640
(773) 794-4698
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31601236
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/09/2006
Last updated
07/08/2007
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