Provider Demographics
NPI:1730127978
Name:KOZIOL, LADONNA R (MD)
Entity Type:Individual
Prefix:
First Name:LADONNA
Middle Name:R
Last Name:KOZIOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 W CENTRAL RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2474
Mailing Address - Country:US
Mailing Address - Phone:847-259-8550
Mailing Address - Fax:847-255-7031
Practice Address - Street 1:1700 W CENTRAL RD
Practice Address - Street 2:SUITE 260
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2474
Practice Address - Country:US
Practice Address - Phone:847-259-8550
Practice Address - Fax:847-255-7031
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG43857Medicare UPIN