Provider Demographics
NPI:1487197240
Name:KONRAD, ELIZABETH (LCPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:KONRAD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1548 BOND ST
Mailing Address - Street 2:STE 114
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-6508
Mailing Address - Country:US
Mailing Address - Phone:630-717-9408
Mailing Address - Fax:
Practice Address - Street 1:1548 BOND ST
Practice Address - Street 2:STE 114
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-6508
Practice Address - Country:US
Practice Address - Phone:630-717-9408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional