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General NPI Number Information
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NPI Number | 1972855989
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Entity Type | Individual
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Provider Name | PAMELA P KONTOS NP
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Gender | Female
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 18350 KEDZIE AVE STE 101
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City | HOMEWOOD
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State | IL
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Zip | 60430-2758
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Country | US
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Telephone | 708-365-1055
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Fax | 708-799-1258
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Provider Business Mailing Address
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Address Line | 17800 KEDZIE AVE DIABETES WELLNESS CENTER
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City | HAZEL CREST
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State | IL
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Zip | 60429-2029
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Country | US
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Telephone | 708-213-3286
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Fax | 708-213-0196
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 209-009859
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209009859
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License Number State | IL
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