Provider Demographics
NPI:1225030687
Name:KIRCH, EVERETT P (MD)
Entity Type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:P
Last Name:KIRCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20 TOWER CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5711
Mailing Address - Country:US
Mailing Address - Phone:847-244-2960
Mailing Address - Fax:847-244-2986
Practice Address - Street 1:20 TOWER CT
Practice Address - Street 2:SUITE C
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5711
Practice Address - Country:US
Practice Address - Phone:847-244-2960
Practice Address - Fax:847-244-2986
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2021-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-050082207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC44172Medicare UPIN