Organization Active NPI

Traci a Kurtzer MD SC

  • Specialist
  • Evanston, IL
National Provider Identifier
1053544759
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036091007 Issued in IL
Legal business name
TRACI A KURTZER MD SC
Practice address
636 Church St Ste 217
Evanston, IL 60201-4578
Phone
(847) 328-0238
NPI assigned
Aug 27, 2009
Last updated
Aug 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Traci A Kurtzer, M.DNPI 1710950464
Title
Owner
Phone
(847) 328-0238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036091007 IL Primary

Addresses

Primary practice location

636 Church St Ste 217
Evanston, IL 60201-4578

Mailing address

636 Church St Ste 217
Evanston, IL 60201-4578
Phone (847) 328-0238

National Provider Directory

National Provider Directory

Locations

636 Church St
Ste 217
Evanston, IL 60201
Phone (847) 328-0238

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1053544759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 217",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014578",
            "telephone_number": "847-328-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 217",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014578",
            "telephone_number": "847-328-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACI A KURTZER MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "KURTZER",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-328-0238",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036091007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.