Provider Demographics
NPI:1669586079
Name:FURMANOV, SERGEY (MD)
Entity type:Individual
Prefix:
First Name:SERGEY
Middle Name:
Last Name:FURMANOV
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 1:150 N RIVER RD STE 270
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1272
Mailing Address - Country:US
Mailing Address - Phone:847-298-8470
Mailing Address - Fax:847-298-6819
Practice Address - Street 1:150 N RIVER RD STE 270
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1272
Practice Address - Country:US
Practice Address - Phone:847-298-8470
Practice Address - Fax:847-298-6819
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK19493Medicare UPIN