| Doctor Name: | MR. THOMAS GREGORY KUERBITZ |
| NPI Number: | 1033420898 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 2725 |
| Business Practice Address: | 300 N Milwaukee Ave Ste D Lake Villa, IL - 600468563 |
| Business Phone Number: | 8473566634 |
| Business Fax Number: | 8473567264 |
| Mailing Address: | 300 N Milwaukee Ave Ste D, LAKE VILLA |
| State: | IL |
| Postal Code: | 600468563 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/27/2010 |
| NPI Last Update Date: | 09/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2725 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |