| Carol Kotzan Md Llc | |
|
360 Station Dr Suite 201 Crystal Lake IL 60014-7978 | |
| (815) 455-7200 | |
| Not Available |
| Full Name | Carol Kotzan Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 360 Station Dr, Crystal Lake, Illinois |
| Authorized Official Name and Position | Carol Anne Kotzan (PRESIDENT) |
| Authorized Official Contact | 8154557200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol Kotzan Md Llc 360 Station Dr Suite 201 Crystal Lake IL 60014-7978 Ph: (815) 455-7200 | Carol Kotzan Md Llc 360 Station Dr Suite 201 Crystal Lake IL 60014-7978 Ph: (815) 455-7200 |
| NPI Number | 1457603557 |
|---|---|
| Provider Enumeration Date | 10/12/2012 |
| Last Update Date | 03/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457603557 | NPI | - | NPPES |
| 036076689 | Medicaid | IL | |
| 5632584 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036076689 (Illinois) | Primary |
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