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Organization
ROMAN OREST KOZYCKYJ
Active
Organization
ROMAN OREST KOZYCKYJ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY GAMEZ (BILLER)
(708) 229-2240
Entity
Organization
Contact information
Practice address
4700 W 95TH ST, SUITE 206, OAK LAWN, IL 60453-2533
(708) 229-2240
(708) 229-2494
Mailing address
4700 W 95TH ST, SUITE 206, OAK LAWN, IL 60453-2533
(708) 229-2240
(708) 229-2494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01625872
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/13/2007
Last updated
04/01/2008
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