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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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