Moazemi, Kourosh
Moazemi, Kourosh is an individual health care provider with primary practice located at 611 W Park St , Urbana IL 61801-2529. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Moazemi, Kourosh can be contacted via phone (217) 383-3129.Contact Information
Primary practice address
611 W Park St
Urbana IL 61801-2529
Phone: (217) 383-3129
Fax: (217) 326-1550
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A78865 | California |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036105401 | Illinois |
Profile Details
| NPI number | 1184774374 |
|---|---|
| LBN Legal business name | Moazemi, Kourosh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2007 |
| Last updated | Dec 31st, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184774374 | NPPES |
| California | Other | A78865 | CA LICENSE |
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