Provider Demographics
NPI:1558362079
Name:KOCHVAR, GUY T (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:T
Last Name:KOCHVAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 W. CENTRAL RD.
Mailing Address - Street 2:SUITE 8100
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005
Mailing Address - Country:US
Mailing Address - Phone:847-255-5030
Mailing Address - Fax:847-255-0156
Practice Address - Street 1:880 W. CENTRAL RD.
Practice Address - Street 2:SUITE 8100
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005
Practice Address - Country:US
Practice Address - Phone:847-255-5030
Practice Address - Fax:847-255-0156
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036080159207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF50091Medicare UPIN