Individual
MRS. PAMELA P KONTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
18350 KEDZIE AVE STE 101, HOMEWOOD, IL 60430-2758
(708) 365-1055
(708) 799-1258
Mailing address
17800 KEDZIE AVE, DIABETES WELLNESS CENTER, HAZEL CREST, IL 60429-2029
(708) 213-3286
(708) 213-0196
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209009859
IL
363LP2300X
Primary Care Nurse Practitioner
209-009859
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36-2169147
—
IL
Enumeration date
10/15/2012
Last updated
05/21/2025
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