Provider Demographics
NPI:1164423687
Name:KURITZA, GEORGE G (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:G
Last Name:KURITZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N HOME AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3066
Mailing Address - Country:US
Mailing Address - Phone:847-823-0430
Mailing Address - Fax:847-823-0431
Practice Address - Street 1:110 N HOME AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-823-0430
Practice Address - Fax:847-823-0431
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360632732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD14946Medicare UPIN
701780Medicare PIN