| Kazkaz Southwest Neurology S.c. | |
|
1890 Silver Cross Blvd Ste 320 New Lenox IL 60451-9610 | |
| (815) 722-8106 | |
| Not Available |
| Full Name | Kazkaz Southwest Neurology S.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1890 Silver Cross Blvd Ste 320, New Lenox, Illinois |
| Authorized Official Name and Position | Bassel Kazkaz (PRESIDENT) |
| Authorized Official Contact | 6088435332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kazkaz Southwest Neurology S.c. 143 Kraml Drive Burr Ridge IL 60527 Ph: (608) 843-5332 | Kazkaz Southwest Neurology S.c. 1890 Silver Cross Blvd Ste 320 New Lenox IL 60451-9610 Ph: (815) 722-8106 |
| NPI Number | 1972167906 |
|---|---|
| Provider Enumeration Date | 04/25/2019 |
| Last Update Date | 04/15/2020 |
| Certification Date | 04/15/2020 |
| Medicare PECOS PAC ID | 0143650036 |
|---|---|
| Medicare Enrollment ID | O20200416001451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972167906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Bassel Kazkaz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336196054 PECOS PAC ID: 1355433889 Enrollment ID: I20140416000097 |
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