Provider Demographics
NPI:1376682724
Name:KONIOR, RAYMOND JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:KONIOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1S280 SUMMIT
Mailing Address - Street 2:SUITE C4
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:630-932-9690
Mailing Address - Fax:630-932-8125
Practice Address - Street 1:1S280 SUMMIT
Practice Address - Street 2:SUITE C4
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:630-932-9690
Practice Address - Fax:630-932-8125
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E18985Medicare UPIN