Provider Demographics
NPI:1033394440
Name:COURET MEDICAL & URGENT CARE S.C.
Entity Type:Organization
Organization Name:COURET MEDICAL & URGENT CARE S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:COURET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-451-4064
Mailing Address - Street 1:2930 MANNHEIM RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2265
Mailing Address - Country:US
Mailing Address - Phone:847-451-4064
Mailing Address - Fax:847-451-4098
Practice Address - Street 1:2930 MANNHEIM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2265
Practice Address - Country:US
Practice Address - Phone:847-451-4064
Practice Address - Fax:847-451-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090038207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632309OtherBCBS PROVIDER #
IL209955Medicare PIN
110235189Medicare PIN