MEDICARE: GREGORY KOZENY 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
1	207RN0300X	Nephrology Physician	036059588	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110059948	OTHER	IL	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1616108	OTHER	IL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861499550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY KOZENY MD

Provider Business Mailing Address
First Line	:	120 W 22ND ST STE 200
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1563
Country	:	US
Telephone Number	:	630-575-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 N WINFIELD RD STE 414
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1379
Country	:	US
Telephone Number	:	630-690-1220
Fax Number	:	630-690-5323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	10/30/2020

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Directions to “ GREGORY KOZENY MD” Practice Location

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