Provider Demographics
NPI:1558606558
Name:KOSGI, KAVYA
Entity Type:Individual
Prefix:MS
First Name:KAVYA
Middle Name:
Last Name:KOSGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-1988
Mailing Address - Country:US
Mailing Address - Phone:224-210-8091
Mailing Address - Fax:
Practice Address - Street 1:1030 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-1988
Practice Address - Country:US
Practice Address - Phone:224-210-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-01
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical