Individual
MARIA KORDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 E ALGONQUIN RD, ALGONQUIN, IL 60102-5446
(224) 713-0003
(224) 678-7122
Mailing address
1212 E ALGONQUIN RD, ALGONQUIN, IL 60102-5446
(630) 232-0280
(630) 232-3895
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209012835
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400268410
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
12/23/2015
Last updated
11/05/2021
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