Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 36106749 | IL |
NPI | 1003893975 |
---|---|
Provider Name | Holly Kramer |
First Address | Maywood, IL 60153 |
Second Address | Maywood, IL 60153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 29/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36106749 | (05) | IL |
H76409 | (02) |