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NPI Code Detail

MEDICARE: LIBORKA KOS M.D.

MEDICARE:   LIBORKA  KOS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207NP0225XPediatric Dermatology Physician036-114831IL

General Provider Information

NPI Number : 1679585210
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIBORKA KOS M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 3232 LAKE AVE
Second Line :
City : WILMETTE
State : IL
Zip : 60091-1073
Country : US
Telephone Number : 847-318-9330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 03/05/2025

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