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Individual

BASSEL KAZKAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1890 SILVER CROSS BLVD STE 345, NEW LENOX, IL 60451
(630) 933-4056
(630) 933-4057
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036096413
IL
2084N0400X
Neurology Physician
38376-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7610
DEAN HEALTH INSURANCE
WI
01
CA4748
MEDICARE RAILROAD (GROUP)
IL
01
P01349679
MEDICARE RAILROAD (INDIVIDUAL)
IL
Enumeration date
05/28/2006
Last updated
09/05/2018
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