Iwona Konczak, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

25632 Issued in CA

Practice address

415 W Golf Rd
Suite 4
Arlington Heights, IL 60005-3929

Phone

(847) 226-1810

NPI assigned

Nov 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1568642015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W BRIAR PL",
            "address_2": "APT 11D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574737",
            "telephone_number": "847-226-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W GOLF RD",
            "address_2": "SUITE 4",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053929",
            "telephone_number": "847-226-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONCZAK",
        "first_name": "IWONA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042297A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-007687",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "25632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "IL7807",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Koentz
• Paul Gregory Kolaski, DC
• Lynda Kolb
• Mark John Koller, DDS
• Julie Kollins, APN
• Barbara Konopka, DN
• Svetlana Konstantinovic, LCPC
• Lynn Marie Konzen
• Erin Kopeny, PA-C
• Kenneth Edward Korber, P.A.

• Clinical Psychologist in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.