Kozlov, David Bradley

Kozlov, David Bradley is an individual health care provider with primary practice located at 1322 Tuneberg Pkwy , Belvidere IL 61008-7902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Kozlov, David Bradley can be contacted via phone (847) 445-4262.

Contact Information

Primary practice address
1322 Tuneberg Pkwy Belvidere IL 61008-7902
Phone: (847) 445-4262
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 31814 Iowa
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 43507-020 Wisconsin
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 036-100483 Illinois
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X ME105953 Florida

Profile Details

NPI number 1528087913
LBN Legal business name Kozlov, David Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Nov 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528087913 NPPES
Illinois Other 212545 GROUP PTAN
Illinois Other 202926 GROUP PTAN
Illinois MEDICAID 036100483 GROUP PTAN

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