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Individual

GEORGE B KUZYCZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
25 N. WINFIELD RD., WINFIELD, IL 60190-1295
(630) 933-4480
(630) 933-2009
Mailing address
25 N. WINFIELD RD., WINFIELD, IL 60190-1295
(630) 933-4480
(630) 933-2009

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036040958
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036040958
IL
01
206147
MEDICARE PTAN (GROUP)
01
CA4748
RAILROAD MEDICARE PTAN (GROUP)
IL
01
P01077990
RAILROAD MEDICARE PTAN (INDIVIDUAL)
IL
01
T01703
MEDICARE PTAN (INDIVIDUAL)
Enumeration date
02/28/2006
Last updated
11/29/2012
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