Individual
DR. DANIEL JAMES KOZUBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
412 NORTH LAKE ST, STE 203, AURORA, IL 60506
(630) 244-7000
(847) 961-5730
Mailing address
412 NORTH LAKE ST, STE 203, AURORA, IL 60506
(630) 244-7000
(847) 961-5730
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003041
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004572024
BLUE CROSS BLUE SHIELD
IL
01
—
054497000
MAGELLAN BEH HEALTH
—
Enumeration date
09/25/2006
Last updated
02/06/2012
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