DR. KURT W ERICKSON (NPI# 1033173125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033173125 |
| Entity Type | Individual |
| Full Name | DR. KURT W ERICKSON |
| Credential | M.D. |
| Practice Address |
11560 S Kedzie Ave Ste 100 Merrionette Park IL 60803-4517 |
| Mailing Address |
13011 S 104th Ave Ste 100 Palos Park IL 60464-1508 |
| Practice Telephone | 7088241114 |
| Practice Fax Number | 7088249341 |
| Mailing Telephone | 7084783600 |
| Mailing Fax Number | 7084783552 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036073183 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
036073183 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP | 236550 | 01 |
| IL | RAILROAD MEDICARE GROUP PTAN NUMBER | CN2703 | 01 |
| BLUE CROSS BLUE SHIELD | 01621208 | 01 | |
| IL | 036073183 | 05 | |
| IL | RAILROAD MEDICARE WILL | 060056644 | 01 |
| IL | MEDICARE GROUP | 236551 | 01 |
| IL | MEDICARE GROUP | 416810 | 01 |
| IL | RAILROAD MEDICARE GROUP PTAN NUMBER | CD8033 | 01 |
| IL | RAILROAD MEDICARE COOK | 060042344 | 01 |
| IL | GROUP NPI | 1508810086 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2338 New St, Blue Island, IL 604062402 | 7088241114 | 7088249341 |
| 13011 S 104th Ave Ste 100, Palos Park, IL 604641508 | 7082743278 | 7082743299 |
| 3231 Euclid Ave Ste 201, Berwyn, IL 604023472 | 7087832055 | 7087832181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720468614 | Kurt Daniel Erickson | Dentist | 1950 Center Creek Dr Ste 200, Fairmont, MN 56031-3430 | 2015-06-04 |
| 1790784445 | Kurt Victore Erickson | Specialist | 1106 Druid Rd S, Sute 301, Clearwater, FL 33756-3846 | 2005-07-15 |
| Street Address |
11560 S KEDZIE AVE STE 100 |
| City | MERRIONETTE PARK |
| State | IL |
| Zip Code | 60803-4517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457315624 | Sean P Tierney | Internal Medicine | 11560 S Kedzie Ave Ste 100, Merrionette Park, IL 60803-4517 | 2006-04-14 |
| 1447450788 | James Paul Sur | Internal Medicine | 11560 S Kedzie Ave Ste 100, Merrionette Park, IL 60803-4517 | 2007-07-24 |
| 1689638702 | Hang-jin H Shin | Internal Medicine | 11560 S Kedzie Ave Ste 100, Merrionette Park, IL 60803-4517 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699173013 | American Medical Lab, Ltd | Clinical Medical Laboratory | 5130 W 125th Pl, American Medical Lab, Alsip, IL 60803 | 2014-12-17 |
| 1225387574 | A Touch of Class Dentistry II | Dentist | 12033 S. Pulaski Road, Alsip, IL 60803 | 2012-08-31 |
| 1841431657 | George P. Danos Inc | Dentist | 5101 W 111th St, Alsip, IL 60803 | 2009-03-09 |
| 1194898114 | Vital Rehabilitation & Physical Therapy Inc | Clinic/Center | 11600 S Kedzie, Merrionette Park, IL 60803 | 2006-11-16 |
| 1841203650 | Alsip Dental Arts PC | Dentist | 11107 South Lawler, Alsip, IL 60803 | 2006-08-14 |
| 1477500932 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 12001 S Pulaski Rd, Alsip, IL 60803 | 2006-05-30 |
| 1013961044 | Arbor Centers for Eye Care | Technician/Technologist | 11600 South Kedzie Ave, Merrionette Park, IL 60803 | 2006-05-22 |
| 1467064360 | Yash Desai | Pharmacist | 12290 S Pulaski Rd, Alsip, IL 60803 | 2020-08-20 |
| 1609293539 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3243 W 115th St, Merrionette Park, IL 60803 | 2014-03-28 |
| 1114357092 | Abdul Hussein Darki | Pediatrics | 11808 S Pulaski Rd, Alsip, IL 60803 | 2013-11-14 |
| Find all providers in zip 60803 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164984514 | Cil Care of Il II, LLC | Internal Medicine | 1900 E Golf Rd Ste 950, Schaumburg, IL 60173-5034 | 2019-04-04 |
| 1467950733 | Coordinated Health of Il, LLC | Internal Medicine | 1900 E Golf Rd Ste 950c, Schaumburg, IL 60173-5834 | 2018-01-31 |
| 1740728039 | Jenna Schrage | Internal Medicine | 317 N 5th St, Springfield, IL 62701-1003 | 2017-02-07 |
| 1417373010 | Hashim Gazi | Internal Medicine | 3331 West Deyoung, Suite 100, Marion, IL 62959 | 2014-03-07 |
| 1992041644 | Daniel Brent Nelson | Internal Medicine | 3810 Farhills Dr, Champaign, IL 61822-9321 | 2012-12-28 |
| 1801184767 | Surya Teja Chaturvedula | Internal Medicine | 5409 N Knoxville Ave Ste 207, Peoria, IL 61614-5069 | 2011-07-13 |
| 1841583952 | C Dean Katsamakis Do Facc Sc | Internal Medicine | 240 Waukegan Rd, Glenview, IL 60025-5159 | 2011-05-23 |
| 1154550119 | Elliott M Groves | Internal Medicine | 840 S Wood St Ste Smc715, Chicago, IL 60612-4325 | 2009-07-10 |
| 1841484813 | Elsayed Mohamed | Internal Medicine | 804 E Woodfield Rd Ste 300, Schaumburg, IL 60173-4776 | 2007-08-31 |
| 1952513335 | Muhammad Sikander Akbar | Internal Medicine | 6300 N Lincoln Ave, Chicago, IL 60659-1204 | 2007-05-05 |
| Find all providers with the same taxonomy | ||||
| City | MERRIONETTE PARK |
| Zip Code | 60803 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.