Organization
ADULT AND PEDIATRIC NEUROLOGY
Active
Organization
ADULT AND PEDIATRIC NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLGA KOZLOVA MD (NEUROLOGIST)
(207) 408-9300
Entity
Organization
Contact information
Practice address
9933 LAWLER AVE STE 313, SKOKIE, IL 60077-3783
(847) 450-7737
(844) 412-9768
Mailing address
677 CARRIAGE HILL DR, GLENVIEW, IL 60025-5402
(207) 408-9300
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
036.133912
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036133912
—
IL
Enumeration date
08/08/2016
Last updated
07/27/2023
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