Individual
ELEANOR KOTOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 N WALL ST, KANKAKEE, IL 60901-2901
(815) 933-1671
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD471833
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
04/10/2017
Last updated
02/20/2024
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