Individual
GREGORY KOZENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 N WINFIELD RD STE 414, WINFIELD, IL 60190-1379
(630) 690-1220
(630) 690-5323
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 575-5000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036059588
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059588
—
IL
01
—
110059948
RAILROAD MEDICARE PIN
IL
01
—
1616108
BCBS
IL
Enumeration date
07/07/2005
Last updated
10/30/2020
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