Basic Information
Provider Information
NPI: 1730296450
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KOSNAR-PARKER
FirstName: AMY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 161 WASHINGTON STREET
Address2: EIGHT TOWER BRIDGE, SUITE 1400
City: CONSHOHOCKEN
State: PA
PostalCode: 19428
CountryCode: US
TelephoneNumber: 4843513200
FaxNumber: 4843513800
Practice Location
Address1: 7251 WEST LAKE STREET
Address2:  
City: RIVER FOREST
State: IL
PostalCode: 60305
CountryCode: US
TelephoneNumber: 8668253227
FaxNumber: 4843513800
Other Information
ProviderEnumerationDate: 08/25/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X209002707ILY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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