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Konstantins Kociasvili, MD
Adult Medicine Physician in Glenview, Illinois
NPI 1588854848

Konstantins Kociasvili is an Adult Medicine Physician based in Buffalo Grove, IL and is specialized in Adult Medicine. Konstantins Kociasvili practices in Glenview, IL and has the professional credentials of MD. The NPI Number for Konstantins Kociasvili is 1588854848 and holds a License No. 036135325 (Illinois).

The current practice location address for Konstantins Kociasvili is 3633 W Lake Ave Ste 307, Glenview, IL and can be reached out via phone at 847-626-8722 and via fax at 847-316-9502.

Location: 3633 W Lake Ave Ste 307, Glenview, IL, 60089-3545
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Provider Profile Details
NPI Number
1588854848
Provider Name
Konstantins Kociasvili
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3633 W Lake Ave Ste 307, Glenview, IL, 60089-3545
Phone Number
847-626-8722
Fax Number
847-316-9502
Provider Enumeration Date
08/01/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
125052607 01 IL 125052607
036135325 05 IL
institution
Provider Business Practice Location Address Details
Address
3633 W Lake Ave Ste 307
City
State
Zip
60026-5803
Phone Number
847-626-8722
Fax Number
847-316-9502
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Provider Business Mailing Address Details
Address
3633 W Lake Ave Ste 307
City
State
Zip
60026-5803
Phone Number
847-626-8722
Fax Number
847-316-9502
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
License No.
036135325 (Illinois)
Definition
Definition to come.
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