Provider Demographics
NPI:1841843828
Name:KURIAN, DALIA (FNP-C)
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:KURIAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 N ASHLAND AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3143
Mailing Address - Country:US
Mailing Address - Phone:773-935-1199
Mailing Address - Fax:773-935-1219
Practice Address - Street 1:3017 N ASHLAND AVE APT 1N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3143
Practice Address - Country:US
Practice Address - Phone:773-935-1199
Practice Address - Fax:773-935-1219
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018529363LA2200X
IL209.018529363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209018529Medicaid
ILMK5870591OtherDEA