Provider Demographics
NPI:1609098953
Name:KOSAR, JOSEPH JOHN JR (DN)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:KOSAR
Suffix:JR
Gender:M
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 ARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1363
Mailing Address - Country:US
Mailing Address - Phone:630-515-9995
Mailing Address - Fax:630-515-9995
Practice Address - Street 1:4524 ARBOR VIEW DR
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1363
Practice Address - Country:US
Practice Address - Phone:630-515-9995
Practice Address - Fax:630-515-9995
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath