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NPI Code Detail

MEDICARE: DR. OLGA KOZLOVA MD

MEDICARE:  DR. OLGA  KOZLOVA  MD
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
12084N0402XNeurology with Special Qualifications in Child Neurology Physician036133912IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477997674
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OLGA KOZLOVA MD
Provider Business Mailing Address
First Line : 9933 LAWLER AVE STE 313
Second Line :
City : SKOKIE
State : IL
Zip : 60077-3783
Country : US
Telephone Number : 847-450-7737
Fax Number : 844-412-9768
Provider Business Practice Location Address
First Line : 9933 LAWLER AVE STE 313
Second Line :
City : SKOKIE
State : IL
Zip : 60077-3783
Country : US
Telephone Number : 847-450-7737
Fax Number : 844-412-9768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2013
Last Update Date : 07/27/2023

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Directions to “ DR. OLGA KOZLOVA MD” Practice Location

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