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NPI Code Detail

MEDICARE: DR. KALEOULOKAWAI STASZKOW M.D.

MEDICARE: DR. KALEOULOKAWAI STASZKOW M.D.
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
1207R00000XInternal Medicine Physician036100828IL

General Provider Information

NPI Number : 1851476907
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KALEOULOKAWAI STASZKOW M.D.
Provider Business Mailing Address
First Line : 676 N ST CLAIR
Second Line : SUITE 2300
City : CHICAGO
State : IL
Zip : 60611-2922
Country : US
Telephone Number : 312-926-6000
Fax Number : 312-926-6323
Provider Business Practice Location Address
First Line : 676 N ST CLAIR
Second Line : SUITE 2300
City : CHICAGO
State : IL
Zip : 60611-2922
Country : US
Telephone Number : 312-926-6000
Fax Number : 312-926-6323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 01/19/2013

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Directions to “ DR. KALEOULOKAWAI STASZKOW M.D.” Practice Location

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