Rezaei, Kourous A

Rezaei, Kourous A is an individual health care provider with primary practice located at 71 W 156Th St Ste 400, Harvey IL 60426-4265. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Rezaei, Kourous A can be contacted via phone (708) 596-8710.

Contact Information

Primary practice address
71 W 156Th St Ste 400 Harvey IL 60426-4265
Phone: (708) 596-8710
Fax: (708) 596-9820
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036108868 Illinois
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 01061504A Indiana
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 036108868 Illinois

Profile Details

NPI number 1366428070
LBN Legal business name Rezaei, Kourous A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Feb 4th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366428070 NPPES
Indiana Other P00440893 RRMC
Indiana MEDICAID 036108868 RRMC
Indiana Other P00264957 RRMC

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