Kozyckyj, Roman O

Kozyckyj, Roman O is an individual health care provider with primary practice located at 6345 W 79Th St , Burbank IL 60459-1133. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Kozyckyj, Roman O can be contacted via phone (844) 725-5238.

Contact Information

Primary practice address
6345 W 79Th St Burbank IL 60459-1133
Phone: (844) 725-5238
Fax: (708) 346-8285
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-063880 Illinois
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 036.063880 Illinois

Profile Details

NPI number 1184603961
LBN Legal business name Kozyckyj, Roman O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2006
Last updated Apr 17th, 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 1184603961 NPPES
Other 01625872 BC BC
MEDICAID 036063880 BC BC

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