Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036-095853 | IL |
N | 208600000X | Surgeon | 036-095853 | IL |
Y | 2082S0105X | Plastic Hand Surgeon | 036-095853 | IL |
NPI | 1346267341 |
---|---|
Provider Name | Dr. Gary Adam Kronen |
First Address | Palos Hills, IL 60465-1971 |
Second Address | Palos Hills, IL 60465-1971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F41598 | (02) | IL |