Kroger, Elliott
Kroger, Elliott is an individual health care provider with primary practice located at 3210 Grand Ave , Waukegan IL 60085-2204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kroger, Elliott can be contacted via phone (847) 220-4103.Contact Information
Primary practice address
3210 Grand Ave
Waukegan IL 60085-2204
Phone: (847) 220-4103
Fax: (847) 693-7029
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-059136 | Illinois |
Profile Details
| NPI number | 1427087063 |
|---|---|
| LBN Legal business name | Kroger, Elliott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2006 |
| Last updated | Mar 27th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427087063 | NPPES |
| Other | 1982624763 | BCBS OF IL | |
| Other | 04-29526 | BCBS OF IL | |
| Other | 4932996 | BCBS OF IL |
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