Provider Demographics
NPI:1750345872
Name:KUNA, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:KUNA
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 1:526 W. STATE STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61101-1214
Mailing Address - Country:US
Mailing Address - Phone:815-968-9300
Mailing Address - Fax:815-968-5314
Practice Address - Street 1:526 W. STATE STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61101-1214
Practice Address - Country:US
Practice Address - Phone:815-968-9300
Practice Address - Fax:815-968-5314
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0700782084P0800X
IL0360700782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209551Medicare PIN
ILP05242Medicare UPIN