Provider Demographics
NPI:1760634752
Name:CONKEY, GENEVIEVE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:
Last Name:CONKEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 SKOKIE BOULEVARD
Mailing Address - Street 2:#204
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-4022
Mailing Address - Country:US
Mailing Address - Phone:847-559-3240
Mailing Address - Fax:847-559-3224
Practice Address - Street 1:899 SKOKIE BOULEVARD
Practice Address - Street 2:#204
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-4022
Practice Address - Country:US
Practice Address - Phone:847-559-3240
Practice Address - Fax:847-559-3224
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007357103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent