Individual
NICHOLAS S KOWALCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE STE MC7082, CHICAGO, IL 60637-1465
(773) 702-6840
(773) 702-2230
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.075939
IL
207RN0300X
Nephrology Physician
Primary
036.163402
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2020
Last updated
06/12/2023
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