Individual
DR. JAMIE LYNN KONDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV PED SAM CLINIC, SAINT LOUIS, MO 63110-1002
(314) 454-2879
(314) 454-2473
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-2879
(314) 454-2473
Taxonomy
Speciality
Code
Description
License number
State
2080C0008X
Child Abuse Pediatrics Physician
Primary
2009015140
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2009015140
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200005663
—
MO
Enumeration date
01/18/2008
Last updated
04/17/2025
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