MEDICARE: CHRISTINA CONDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146009966	IL

General Provider Information

NPI Number	:	1639424757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA CONDE

Provider Business Mailing Address
First Line	:	3823 N LAWNDALE AVE
Second Line	:	APT. 1E
City	:	CHICAGO
State	:	IL
Zip	:	60618-4136
Country	:	US
Telephone Number	:	773-218-0797
Fax Number	:

Provider Business Practice Location Address
First Line	:	3823 N LAWNDALE AVE
Second Line	:	APT. 1E
City	:	CHICAGO
State	:	IL
Zip	:	60618-4136
Country	:	US
Telephone Number	:	773-218-0797
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2012
Last Update Date	:	07/14/2012

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Directions to “ CHRISTINA CONDE ” Practice Location

Language	Start Address	Practice Location

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