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Individual
DR. GERALDINE MARIE KRUCKENBERG
Active
Individual
DR. GERALDINE MARIE KRUCKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038 007464
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038 007464
—
IL
01
—
08132048
BCBS
—
01
—
1179978
IA PUBLIC AID
—
01
—
P00174127
MEDICARE RAILROAD
IL
Enumeration date
08/10/2005
Last updated
06/26/2014
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