Provider Demographics
NPI:1912347568
Name:SKURA, KATARZYNA ANNA (MD)
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:ANNA
Last Name:SKURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATARZYNA
Other - Middle Name:ANNA
Other - Last Name:STRYCHARZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:680 N. LAKE SHORE DRIVE SUITE 118
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-470-8990
Mailing Address - Fax:312-846-1300
Practice Address - Street 1:680 N. LAKE SHORE DRIVE SUITE 118
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-470-8990
Practice Address - Fax:312-846-1300
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036138637207R00000X
IL036.138637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400319875Medicare UPIN