Provider Demographics
NPI:1427229756
Name:CONDUX, KATHRYN LYNN (MBA, ATC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:LYNN
Last Name:CONDUX
Suffix:
Gender:F
Credentials:MBA, ATC
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:LYNN
Other - Last Name:DASTYCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBA, ATC
Mailing Address - Street 1:584 COMMANCHE CT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-1548
Mailing Address - Country:US
Mailing Address - Phone:630-479-5714
Mailing Address - Fax:
Practice Address - Street 1:584 COMMANCHE CT
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-1548
Practice Address - Country:US
Practice Address - Phone:630-479-5714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0025852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer