Provider Demographics
NPI:1871529057
Name:DRS JURCIK & HANTOS SC
Entity type:Organization
Organization Name:DRS JURCIK & HANTOS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LIVIA
Authorized Official - Middle Name:ERIKA
Authorized Official - Last Name:HANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-541-4010
Mailing Address - Street 1:1604 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3908
Mailing Address - Country:US
Mailing Address - Phone:847-541-4010
Mailing Address - Fax:847-541-0159
Practice Address - Street 1:1604 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3908
Practice Address - Country:US
Practice Address - Phone:847-541-4010
Practice Address - Fax:847-541-0159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0420060992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL721221Medicare ID - Type UnspecifiedGRP. MEDICARE #