Individual
CONRAD JAMES BURGHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 GREEN BAY RD, KENILWORTH, IL 60043-1001
(847) 919-9096
Mailing address
2025 SHERMAN AVE APT 301, EVANSTON, IL 60201-3267
(847) 749-8796
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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