Organization
IHC-SWEDISHAMERICAN EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
1625 S STATE ST, BELVIDERE, IL 61008-5907
(973) 251-1132
(414) 290-6755
Mailing address
PO BOX 80274, PHILADELPHIA, PA 19101-1274
(973) 251-1132
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/22/2017
Last updated
12/09/2019
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