Organization
MONROE MEDICAL ASSOCIATES, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK F KOZLOFF MD (CEO / SENIOR PARTNER)
(708) 339-4800
Entity
Organization
Contact information
Practice address
71 W 156TH ST, SUITE 401, HARVEY, IL 60426-4260
(708) 339-4800
(708) 339-4814
Mailing address
801 MACARTHUR BLVD, SUITE 401, MUNSTER, IN 46321-2915
(219) 836-2860
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
042003867
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042003867
IL REG MED CORP #
IL
05
—
100394430
—
IN
01
—
105630
ANTHEM B S GRP PROV #
IN
01
—
1615180
B C B S GROUP PROV #
IL
Enumeration date
06/09/2006
Last updated
10/07/2010
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