Ivan Kukhar MD SC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

036124664 Issued in IL

Legal business name

IVAN KUKHAR MD SC

Practice address

2701 17TH St
Rock Island, IL 61201-5351

Phone

(800) 444-6110

Fax

(847) 615-2858

NPI assigned

Jul 11, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Ivan Kukhar, MDNPI 1871704072

Title

Owner

Phone

(773) 470-9082

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ivan Bogdanovych Kukhar, MD

  • Pain Medicine (Anesthesiology) Physician
  • Silvis, IL
  • NPI 1871704072

  IA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1639467749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450689",
            "telephone_number": "847-615-2200",
            "fax_number": "847-615-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "800-444-6110",
            "fax_number": "847-615-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN KUKHAR MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-11",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "KUKHAR",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-470-9082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036124664",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036124664",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036124664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ireland Army Community Hospital
• Jeremy Irving, MD
• Patrcik Irving, DO
• Dianna Irwin
• Shannon Geisell Isadore, COTA/L
• Charlotte Consuelo Jackson
• Elizabeth Jackson, RN
• Taylor Jackson
• Taylor Jessica Jackson, MHP
• Westasia Jackson

• Pain Medicine (Anesthesiology) Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.