Individual
ROMAN O KOZYCKYJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6345 W 79TH ST, BURBANK, IL 60459-1133
(844) 725-5238
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-063880
IL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
036.063880
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01625872
BC BC
—
05
—
036063880
—
IL
Enumeration date
01/11/2006
Last updated
01/27/2025
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