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Individual

ILAN D. KOLKOWITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
214 S RANDALL AVE, MADISON, WI 53715-1544
(650) 906-8289
Mailing address
214 S RANDALL AVE, MADISON, WI 53715-1544

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
71357-20
WI
208600000X
Surgery Physician
125.070938
IL

Other

Enumeration date
06/15/2017
Last updated
07/06/2021
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