Basic Information
| Provider Information | |||||||||
| NPI: | 1457379976 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KONOWITZ | ||||||||
| FirstName: | HOWARD | ||||||||
| MiddleName: | STEVEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1171 | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600156002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479454550 | ||||||||
| FaxNumber: | 8479488103 | ||||||||
| Practice Location | |||||||||
| Address1: | 2750 S RIVER RD | ||||||||
| Address2: | |||||||||
| City: | DES PLAINES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474708740 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 07/23/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 36067918 | IL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207R00000X | 39067918 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207L00000X | 36067918 | IL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | P00372337 | 01 | IL | RAILROAD MEDICARE | OTHER | O50073635 | 01 | IL | RAILROAD MEDICARE | OTHER | 36067918 | 05 | IL | MEDICAID |