Provider Demographics
NPI:1780681973
Name:OLSON, MARGARET COZZI (DPM)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:COZZI
Last Name:OLSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ANN
Other - Last Name:COZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:727 BONNIE BRAE PL
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1930
Mailing Address - Country:US
Mailing Address - Phone:708-217-4778
Mailing Address - Fax:
Practice Address - Street 1:727 BONNIE BRAE PL
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1930
Practice Address - Country:US
Practice Address - Phone:708-217-4778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003260213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016003260Medicaid
IL016003260Medicaid
670271Medicare PIN