Provider Demographics
NPI:1710950464
Name:KURTZER, TRACI A (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACI
Middle Name:A
Last Name:KURTZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TRACI
Other - Middle Name:L
Other - Last Name:ARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:636 CHURCH ST
Mailing Address - Street 2:STE 217
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201
Mailing Address - Country:US
Mailing Address - Phone:847-328-0238
Mailing Address - Fax:847-328-1425
Practice Address - Street 1:636 CHURCH ST
Practice Address - Street 2:STE 217
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:847-328-0238
Practice Address - Fax:847-328-1425
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632915OtherBCBS
G55966Medicare UPIN
IL208678Medicare ID - Type Unspecified