Individual
DR. ANDREW L KAZANIWSKYJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
15505 E 127TH ST STE 100, LEMONT, IL 60439-4433
(630) 257-5400
Mailing address
15505 E 127TH ST STE 100, LEMONT, IL 60439-4433
(630) 257-5400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036061149
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061149
—
IL
Enumeration date
01/12/2006
Last updated
07/21/2020
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