# WABASH EM I MEDICAL SERVICES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013110295
- **Authorized official:** KATHY KONDAS (OFFICER)
- **Authorized official phone:** (954) 838-2371

## Contact information

- **Practice address:** 1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
- **Practice address phone:** (574) 753-7541
- **Practice address fax:** (574) 753-1507
- **Mailing address:** 533 W NORTH AVE, STE. 102, ELMHURST, IL 60126-2135
- **Mailing address phone:** (800) 732-1066
- **Mailing address fax:** (630) 941-4333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | IN | Yes |
| 363L00000X | Nurse Practitioner | — | IN | — |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 08/12/2019