Organization
WABASH EM I MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(954) 838-2371
Entity
Organization
Contact information
Practice address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 753-7541
(574) 753-1507
Mailing address
533 W NORTH AVE, STE. 102, ELMHURST, IL 60126-2135
(800) 732-1066
(630) 941-4333
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IN
363L00000X
Nurse Practitioner
—
IN
Other
Enumeration date
06/06/2007
Last updated
08/12/2019
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