Individual
TOMASZ A KOSIERKIEWICZ X
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2605 MAIN ST, MOUNT VERNON, IL 62864-2372
(618) 242-7350
Mailing address
PO BOX 2277, MOUNT VERNON, IL 62864-0044
(618) 242-7350
(618) 242-7651
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036104826
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361048261
—
IL
01
—
04130321
BCBS
IL
01
—
078159
HEALTH ALLIANCE
IL
01
—
130024619
RAILROAD MEDICARE
IL
01
—
463609
HEALTHLINK
IL
Enumeration date
11/04/2005
Last updated
02/21/2012
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