Individual
AMY KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-014211
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-014211
PT STATE LICENSE #
IL
Enumeration date
01/09/2007
Last updated
06/12/2013
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