P JOHN KONICKI

BLOOMINGTON, IN
NPI1336152891
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IN  02005798A)
Additional Taxonomies207PE0004X Emergency Medicine, Emergency Medical Services
(Licence: IL  036091309)
Enumeration Date2006-08-15
Last Update Date2020-10-23
Business Address
P JOHN KONICKI DO
601 W 2ND ST
BLOOMINGTON, IN 47403-2317
Phone number: 812-353-5252
Mailing Address
P JOHN KONICKI DO
4440 W 95TH ST DEPARTMENT OF EMERGENCY MEDICINE
OAK LAWN, IL 60453-2600
Phone number: 708-684-5354