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Individual

LARISA KONONOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
24508 W VILLAGE CTR DR, PLAINFIELD, IL 60544-1885
(815) 439-9400
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-128876
IL
2084P0800X
Psychiatry Physician
2006006803
MO

Other

Enumeration date
02/04/2007
Last updated
08/13/2024
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