Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 125065457 | IL |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 036-152997 | IL |
N | 207XS0106X | Orthopaedic Hand Surgeon | A161234 | CA |
NPI | 1053738385 |
---|---|
Provider Name | Ellen V. Kroin |
First Address | Chicago, IL 60674-1536 |
Second Address | Lombard, IL 60148-4932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 06/01/2021 |