Provider Demographics
NPI:1285638759
Name:CURTIN, JEFFREY C (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:CURTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7831 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-2387
Mailing Address - Country:US
Mailing Address - Phone:847-873-9367
Mailing Address - Fax:224-246-8127
Practice Address - Street 1:7831 W 95TH ST
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2387
Practice Address - Country:US
Practice Address - Phone:847-873-9367
Practice Address - Fax:224-246-8127
Is Sole Proprietor?:No
Enumeration Date:2005-06-12
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084568207Q00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084568OtherLICENSE NUMBER
IL036084568OtherLICENSE
IL036084568Medicaid
ILF59858Medicare UPIN
IL428560Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER