| Adult And Pediatric Neurology | |
|
9933 Lawler Ave Ste 313 Skokie IL 60077-3783 | |
| (847) 450-7737 | |
| (844) 412-9768 |
| Full Name | Adult And Pediatric Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9933 Lawler Ave Ste 313, Skokie, Illinois |
| Authorized Official Name and Position | Olga Kozlova (NEUROLOGIST) |
| Authorized Official Contact | 2074089300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult And Pediatric Neurology 677 Carriage Hill Dr Glenview IL 60025-5402 Ph: (207) 408-9300 | Adult And Pediatric Neurology 9933 Lawler Ave Ste 313 Skokie IL 60077-3783 Ph: (847) 450-7737 |
| NPI Number | 1720532773 |
|---|---|
| Provider Enumeration Date | 08/08/2016 |
| Last Update Date | 07/27/2023 |
| Certification Date | 07/27/2023 |
| Medicare PECOS PAC ID | 0446539092 |
|---|---|
| Medicare Enrollment ID | O20161222000827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720532773 | NPI | - | NPPES |
| 036133912 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | 036.133912 (Illinois) | Primary |
| Provider Name | Olga Geniyevna Kozlova |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477997674 PECOS PAC ID: 5991924763 Enrollment ID: I20140910001963 |
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