Provider Demographics
NPI:1598925554
Name:KONJURA, PC
Entity Type:Organization
Organization Name:KONJURA, PC
Other - Org Name:HORIZON PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONJURA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-662-1968
Mailing Address - Street 1:1200 N GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2246
Mailing Address - Country:US
Mailing Address - Phone:847-662-1968
Mailing Address - Fax:847-249-8218
Practice Address - Street 1:1200 N GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2246
Practice Address - Country:US
Practice Address - Phone:847-662-1968
Practice Address - Fax:847-249-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-012489261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy