Provider Demographics
NPI:1831130129
Name:CROWE, KURT (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:CROWE
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 1:305 E. JOE DRIVE, BOX 231
Mailing Address - Street 2:KSB CENTER FOR HEALTH SERVICES/AMBOY
Mailing Address - City:AMBOY
Mailing Address - State:IL
Mailing Address - Zip Code:61310
Mailing Address - Country:US
Mailing Address - Phone:815-857-3044
Mailing Address - Fax:815-857-2010
Practice Address - Street 1:305 E. JOE DRIVE
Practice Address - Street 2:KSB CENTER FOR HEALTH SERVICES/AMBOY
Practice Address - City:AMBOY
Practice Address - State:IL
Practice Address - Zip Code:61310
Practice Address - Country:US
Practice Address - Phone:815-857-3044
Practice Address - Fax:815-857-2010
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36102549207P00000X
IL036-102549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102549Medicaid
ILK33934OtherMEDICARE
IL930097648OtherRRMCR