Provider Demographics
NPI:1932724341
Name:KURIAN, TONI (NP)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:KURIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S INDIANA AVE APT 407
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-4822
Mailing Address - Country:US
Mailing Address - Phone:847-863-3457
Mailing Address - Fax:
Practice Address - Street 1:1550 S INDIANA AVE APT 407
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-4822
Practice Address - Country:US
Practice Address - Phone:847-863-3457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021270207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine