Organization
KOZIOL PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD KOZIOL PSYD (OWNER)
(847) 686-3643
Entity
Organization
Contact information
Practice address
3800 N WILKE RD, SUITE 160, ARLINGTON HTS, IL 60004-1278
(847) 686-3643
Mailing address
PO BOX 1457, PALATINE, IL 60078-1457
(847) 686-3643
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04672011
BLUE SHIELD
IL
Enumeration date
03/26/2007
Last updated
12/27/2007
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