Individual
MALLORY PAULETTE KOSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 W 95TH ST STE 413, OAK LAWN, IL 60453-2662
(708) 346-4055
Mailing address
2342 W BLOOMINGDALE AVE APT 403, CHICAGO, IL 60647-5616
(603) 965-5456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008163
IL
Other
Enumeration date
09/14/2021
Last updated
12/16/2025
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