GLORY KOSMATKA


Address: 800 Main St Ste 5, Antioch, IL 60002-1542
Phone: 8478389904

GLORY KOSMATKA (NPI# 1114399219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114399219
Entity Type Individual
Full Name GLORY KOSMATKA
Practice Address 800 Main St Ste 5
Antioch
IL 60002-1542
Mailing Address Po Box 887
Lake Villa
IL 60046-0887
Practice Telephone 8478389904
Mailing Telephone 8478389904
Enumeration Date 2015-10-28
Last Update Date 2015-10-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
180005858 IL Behavioral Health & Social Service Providers

Office Location

Street Address 800 MAIN ST STE 5
City ANTIOCH
State IL
Zip Code 60002-1542

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1821620345 Kathleen Ann Bleyaert Technician 24238 W. Bayview Rd, Antioch, IL 60002 2020-02-12
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1689023558 Shannon Marie Herman Pharmacist 966 Route 59, Antioch, IL 60002 2016-06-10
1992151856 Suchitra Gosavi Physical Therapist 3703west Lake Ave, Suit 200, Glenview, IL 60002 2016-05-10
1336513357 Athletico Ltd Physical Therapist 1122 Main St., Antioch, IL 60002 2015-11-16
1811306335 Jennifer Fitzgerald Massage Therapist 673 Cameron Drive, Antioch, IL 60002 2014-08-08
1114262052 Michael W Silenzi Physical Therapist 543 Orchard Str, Antioch, IL 60002 2012-12-04
1659561678 Expert Home Medical Equipment LLC Durable Medical Equipment & Medical Supplies 40225 N Rt 83, Suite B, Antioch, IL 60002 2007-07-26
1821157769 Robert T Sven,dds,ltd Dentist 439 Lake Street, Antioch, IL 60002 2006-12-06
1447326004 Stanley Jerome Witkiewicz Dentist 715 N Main, Antioch, IL 60002 2006-11-27
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720699648 Khamaria Wright Counselor 5160 Rice Rd Apt 236, Antioch, TN 37013-2041 2020-08-13
1316562580 Joseph James Benton Counselor 2495 Vallecito Way, Antioch, CA 94531-9066 2020-06-12
1902381593 New Leaf Counseling LLC Counselor 311 W Depot St Ste F, Antioch, IL 60002-1500 2018-09-28
1144748690 Andrea Michelle Newberry Counselor 55 E.18th St, Antioch, CA 94509 2017-09-05
1629420013 Jessica Rivers Counselor 1480 Rice Hill Cir, Antioch, TN 37013-2199 2016-07-08
1518313055 Alisha Lampley Counselor 804 Thomas Bay Court, Antioch, TN 37013 2016-05-13
1376909341 Toy Lisa Mitchell Counselor 4804 Trappers Rdg, Antioch, TN 37013-2707 2016-01-06
1386019602 Abdullah Hassaan Counselor 3304 Timber Trl, Antioch, TN 37013-1011 2015-12-11
1528459344 Jared Prentiss Counselor 5320 Hickory Hollow Pkwy, Antioch, TN 37013-3128 2015-02-16
1679987887 Mahmood Ketabchi Counselor 3700 Delta Fair Blvd Ste 200b, Antioch, CA 94509-4072 2014-06-16
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Competitor

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City ANTIOCH
Zip Code 60002

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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