Provider Demographics
NPI:1417995887
Name:KUROWSKI, KURT (MD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:KUROWSKI
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 1:140 B SCHOOL CREEK TRAIL
Mailing Address - Street 2:
Mailing Address - City:LUXEMBURG
Mailing Address - State:WI
Mailing Address - Zip Code:54217-1095
Mailing Address - Country:US
Mailing Address - Phone:920-845-1370
Mailing Address - Fax:
Practice Address - Street 1:440 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-3361
Practice Address - Country:US
Practice Address - Phone:626-963-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036071095207Q00000X, 207QA0000X
WI45654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35374500Medicaid
IL336-034932OtherCONTROLLED SUBSTANCE
AK3276854OtherDEA
WI330000037Medicare Oscar/Certification
WIP00815981Medicare Oscar/Certification
IL336-034932OtherCONTROLLED SUBSTANCE
WI35374500Medicaid
WI802100027Medicare Oscar/Certification
AK3276854OtherDEA
WI073100043Medicare Oscar/Certification
WI000026Medicare Oscar/Certification
WI000086Medicare Oscar/Certification