Provider Demographics
NPI:1992818991
Name:KUHN, MATTHEW J (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:KUHN
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 1:611 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-5327
Mailing Address - Country:US
Mailing Address - Phone:217-544-2149
Mailing Address - Fax:217-544-9553
Practice Address - Street 1:800 E CARPENTER ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-5324
Practice Address - Country:US
Practice Address - Phone:217-544-6464
Practice Address - Fax:217-525-5671
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36076919Medicaid
ILP00028352OtherRR MEDICARE
ILP00648Medicare PIN
ILP00028352OtherRR MEDICARE
ILB95302Medicare UPIN