Kruckenberg, Geraldine Marie

Kruckenberg, Geraldine Marie is an individual health care provider with primary practice located at 1715 5Th Ave , Moline IL 61265-7911. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Kruckenberg, Geraldine Marie can be contacted via phone (309) 764-9255.

Contact Information

Primary practice address
1715 5Th Ave Moline IL 61265-7911
Phone: (309) 764-9255
Fax: (309) 762-1064
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038 007464 Illinois

Profile Details

NPI number 1225039324
LBN Legal business name Kruckenberg, Geraldine Marie
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Jun 26th, 2014 - about 10 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225039324 NPPES
Other 08132048 BCBS
Other 1179978 BCBS
MEDICAID 038 007464 BCBS
Other P00174127 BCBS

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