Kathryn Lynn Condux, MBA, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.002585 Issued in IL

Practice address

584 Commanche CT
Carol Stream, IL 60188-1548

Phone

(630) 479-5714

NPI assigned

Mar 14, 2008

Last updated

Apr 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kathryn Lynn Dastych Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1427229756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 COMMANCHE CT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881548",
            "telephone_number": "630-479-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 COMMANCHE CT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881548",
            "telephone_number": "630-479-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDUX",
        "first_name": "KATHRYN",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MBA, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.002585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "DASTYCH",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "MBA, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Athletic Trainer in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.