Individual
ANTONI J KOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3307 LOGAN DR STE B, HERRIN, IL 62948-3732
(618) 997-3461
(618) 993-6042
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 997-3461
(618) 993-6042
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036109286
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109286
—
IL
01
—
130745
HEALTH ALLIANCE
IL
01
—
3932056
BCBS OF IL
IL
01
—
7210895
AETNA
IL
01
—
779555
HEALTHLINK
IL
Enumeration date
06/18/2006
Last updated
03/22/2012
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