Provider Demographics
NPI:1053306076
Name:KREVITZ, CURT S (DPM)
Entity type:Individual
Prefix:DR
First Name:CURT
Middle Name:S
Last Name:KREVITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 E ERIE ST
Mailing Address - Street 2:SUITE 2230
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2987
Mailing Address - Country:US
Mailing Address - Phone:312-926-6000
Mailing Address - Fax:312-926-8267
Practice Address - Street 1:259 E ERIE ST
Practice Address - Street 2:SUITE 2230
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2987
Practice Address - Country:US
Practice Address - Phone:312-926-6000
Practice Address - Fax:312-926-8267
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003379213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1245580001OtherDME NATIONAL GOVERNMENT SERVICES
IL016003379OtherBCBS
IL480019879OtherRR MEDICARE
ILK25691OtherMEDICARE NSC
IL016003379Medicaid
ILK25691OtherMEDICARE PTAN
ILK25691OtherMEDICARE NSC