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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. COREY DANE KONIECZKI, DMD

Deactivated

DR. COREY DANE KONIECZKI, DMD is a Student (Health Education/Training) healthcare provider located in LOVES PARK, Illinois. NPI 1477132561 is deactivated in the NPPES registry. Verify at CMS.

Student (Health Education/Training) · LOVES PARK, IL

This NPI has been deactivated. The record was deactivated on May 9, 2021. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1477132561
Provider Type
Individual
Gender
Male
NPI Issued
Apr 6, 2021 (0.09041095890411 yrs)
Last Updated
Jun 25, 2021
Deactivated
May 9, 2021

Practice Information

Address
2028 E RIVERSIDE BLVD STE 210
LOVES PARK, IL, 611114800
Browse IL providers · Browse ZIP 61111
Phone
8153154073
Primary Specialty
Student (Health Education/Training)
390200000X

Other Student (Health Education/Training) Providers in LOVES PARK, IL

Name Credential NPI
DR. THOMAS AWINE AKURUGO MD, DPT 1588128011
MONICA MANHAS MD 1295297489
DR. HARSHRAJ SINGH SIDHU M.D. 1073196739
MS. NAMRATA ANAND MD 1811570914
DR. TOBIN JOHNSON CHEMPLAVIL DO 1356086607
DR. BENEDICT IKEUDENTA III MD 1477256931
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.