Individual
STEPHEN HERBERT KOZLOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 STATION DR, CRYSTAL LAKE, IL 60014-7978
(815) 338-6600
Mailing address
360 STATION DR, CRYSTAL LAKE, IL 60014-7978
(815) 338-6600
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036-053309
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01915167
BLUE CROSS/BLUE SHIELD
IL
01
—
0359580001
DMERC
IL
01
—
112318
HEALTH ALLIANCE
IL
Enumeration date
08/20/2006
Last updated
07/21/2022
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