Provider Demographics
NPI:1386669703
Name:LOUZON, HARVEY (MD)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:LOUZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 CHARLEMAGNE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2112
Mailing Address - Country:US
Mailing Address - Phone:847-480-8982
Mailing Address - Fax:
Practice Address - Street 1:CALIFORNIA AVE. AT 15TH ST.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1797
Practice Address - Country:US
Practice Address - Phone:773-542-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-061219207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036061219Medicaid
IL036115454Medicaid
IL036115454Medicaid
ILK39301Medicare PIN
ILK15769Medicare PIN