Individual
DR. KRISTI LYN KOZLOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLC
Contact information
Practice address
3100 OGDEN AVE, LISLE, IL 60532-1603
(630) 527-1920
(630) 527-0125
Mailing address
650 SPRING HILL RING RD, STE 2020, WEST DUNDEE, IL 60118-1297
(312) 771-2007
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036103302
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02233058
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/14/2006
Last updated
04/21/2016
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