Konicki, P John

Konicki, P John is an individual health care provider with primary practice located at 601 W 2Nd St , Bloomington IN 47403-2317. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Konicki, P John can be contacted via phone (812) 353-5252.

Contact Information

Primary practice address
601 W 2Nd St Bloomington IN 47403-2317
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 036091309 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 02005798A Indiana

Profile Details

NPI number 1336152891
LBN Legal business name Konicki, P John
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2006
Last updated Oct 23rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336152891 NPPES
Illinois MEDICAID 36091309

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