Provider Demographics
NPI:1609656529
Name:KONDAS, COURTNAY
Entity Type:Individual
Prefix:
First Name:COURTNAY
Middle Name:
Last Name:KONDAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8758
Mailing Address - Country:US
Mailing Address - Phone:630-640-8106
Mailing Address - Fax:
Practice Address - Street 1:800 W 5TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4945
Practice Address - Country:US
Practice Address - Phone:630-779-0751
Practice Address - Fax:630-753-0942
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional