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NPI Code Detail

MEDICARE: G R KOZINA, DDS & ASSOC, LTD

MEDICARE: G R KOZINA, DDS & ASSOC, LTD
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
11223G0001XGeneral Practice DentistryIL

General Provider Information

NPI Number : 1487700555
Entity Type Code : Organization
Provider Name (Legal Business Name) : G R KOZINA, DDS & ASSOC, LTD
Provider Business Mailing Address
First Line : PO BOX 1404
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-8404
Country : US
Telephone Number : 847-689-3800
Fax Number : 847-689-0191
Provider Business Practice Location Address
First Line : 2127 GREEN BAY RD
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-2801
Country : US
Telephone Number : 847-689-3800
Fax Number : 847-689-0191
Authorized Official
Title or Position : PRACTICE MANAGER
Name : MS. LAURA FORMICOLA
Credential :
Telephone Number : 847-689-3800
Provider Enumeration Date : 01/25/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1649326786 — DR. GUSTAV R KOZINA D.D.S.
Practice Location Address:
2127 GREEN BAY RD
NORTH CHICAGO, IL
60064-2801
Practice Phone: 847-689-3800
Practice Fax:
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1578619607 — DR. RITU MALHOTRA D.D.S.
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Practice Fax:
1346395456 — DR. BHARTI R PATIL D.D.S.
Practice Location Address:
2127 GREEN BAY RD
NORTH CHICAGO, IL
60064-2801
Practice Phone: 847-689-3800
Practice Fax:
1164622957 — KHAIRUNNISA SHAIKH D.D.D.S
Practice Location Address:
2127 GREEN BAY RD
NORTH CHICAGO, IL
60064-2801
Practice Phone: 847-689-3800
Practice Fax:
1821282625 — MR. JOSE QUIROGA PERALTA
Practice Location Address:
2127 GREEN BAY RD
NORTH CHICAGO, IL
60064-2801
Practice Phone: 847-689-3800
Practice Fax: 847-689-0191

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