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Individual

JOHN NICHOLAS KASIMOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
20201 CRAWFORD AVE, ST JAMES HOSPITAL OLYMPIA FIELDS CAMPUS, OLYMPIA FIELDS, IL 60461-1010
(708) 747-4000
(708) 503-3242
Mailing address
113 E 4TH ST, MICHIGAN CITY, IN 46360-3301
(219) 873-3130
(219) 873-3132

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01630255
BC/BS
IL
Enumeration date
08/25/2005
Last updated
04/15/2008
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