Provider Demographics
NPI:1336164441
Name:CONNOR, GWENDOLYN STEFFEN (MS, CGC)
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:STEFFEN
Last Name:CONNOR
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 OLIPHANT AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1048
Mailing Address - Country:US
Mailing Address - Phone:312-607-6935
Mailing Address - Fax:
Practice Address - Street 1:250 E SUPERIOR ST RM 5-2221
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2914
Practice Address - Country:US
Practice Address - Phone:312-472-4153
Practice Address - Fax:312-472-4564
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS