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NPI Code Detail

MEDICARE: ELIZABETH KOS

MEDICARE: ELIZABETH KOS
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1033602321
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH KOS
Provider Business Mailing Address
First Line : 2504 N WILLETTS CT UNIT 3S
Second Line :
City : CHICAGO
State : IL
Zip : 60647-7704
Country : US
Telephone Number : 708-717-9488
Fax Number :
Provider Business Practice Location Address
First Line : 6639 N KEDZIE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60645-4161
Country : US
Telephone Number : 773-765-3131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2018
Last Update Date : 06/11/2018

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Directions to “ ELIZABETH KOS ” Practice Location

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