person
Dr. Corey Dane Konieczki, DMD
Student in an Organized Health Care Education/Training Program in Loves Park, Illinois
NPI 1477132561

Corey Dane Konieczki is a Student in an Organized Health Care Education/Training Program based in Rockford, IL. Corey Dane Konieczki practices in Loves Park, IL and has the professional credentials of DMD. The NPI Number for Corey Dane Konieczki is 1477132561 and holds a License No. (Illinois).

The current practice location address for Corey Dane Konieczki is 2028 E Riverside Blvd Ste 210, Loves Park, IL and can be reached out via phone at 815-315-4073.

Location: 2028 E Riverside Blvd Ste 210, Loves Park, IL, 61114-7063
person
Provider Profile Details
NPI Number
1477132561
Provider Name
Corey Dane Konieczki
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
2028 E Riverside Blvd Ste 210, Loves Park, IL, 61114-7063
Phone Number
815-315-4073
Fax Number
Provider Enumeration Date
04/06/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2028 E Riverside Blvd Ste 210
City
State
Zip
61111-4800
Phone Number
815-315-4073
Fax Number
person
Provider Business Mailing Address Details
Address
2028 E Riverside Blvd Ste 210
City
State
Zip
61111-4800
Phone Number
815-315-4073
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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