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NPI Code Detail

MEDICARE: JOHN ALLEN KOWALSKI

MEDICARE: JOHN ALLEN KOWALSKI
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
1207RI0200XInfectious Disease Physician036053307IL

General Provider Information

NPI Number : 1235178708
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ALLEN KOWALSKI
Provider Business Mailing Address
First Line : 1301 W MADISON ST
Second Line : UNIT 523
City : CHICAGO
State : IL
Zip : 60607-1936
Country : US
Telephone Number : 312-666-5753
Fax Number :
Provider Business Practice Location Address
First Line : 2020 W HARRISON ST
Second Line : SUITE 1266
City : CHICAGO
State : IL
Zip : 60612-3741
Country : US
Telephone Number : 312-572-4739
Fax Number : 312-572-4719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 04/26/2013

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