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General NPI Number Information
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NPI Number | 1699650937
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Entity Type | Individual
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Provider Name | GINA MICHELE KOZAR
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Gender | Female
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 5465 GRAND AVE STE 101
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City | GURNEE
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State | IL
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Zip | 60031-4913
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Country | US
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Telephone | 224-303-4396
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Fax | 224-214-3154
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Provider Business Mailing Address
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Address Line | 5465 GRAND AVE STE 101
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City | GURNEE
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State | IL
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Zip | 60031-4913
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Country | US
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Telephone | 224-303-4396
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Fax | 224-214-3154
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 150117764
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150117764
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License Number State | IL
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