Individual
DR. NICHOLAS KONDELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2100 CLEARWATER DR STE 100, OAK BROOK, IL 60523-1931
(630) 607-1000
(630) 607-1002
Mailing address
2100 CLEARWATER DR STE 100, OAK BROOK, IL 60523-1931
(630) 581-3801
(630) 607-1002
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036070815
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036070815
IL
208VP0014X
Interventional Pain Medicine Physician
Primary
036070815
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02233277
BLUE SHIELD OF ILLINOIS
IL
05
—
036070815
—
IL
Enumeration date
06/13/2006
Last updated
03/24/2025
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