Individual
KATHLEEN L KRETCHMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., C.D.E
Contact information
Practice address
360 STATION DR, CRYSTAL LAKE, IL 60014-7978
(815) 338-6600
(815) 356-2388
Mailing address
360 STATION DR, CRYSTAL LAKE, IL 60014-7978
(815) 338-6600
(815) 356-2388
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
041304879
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
962341
MEDICARE PTAN
IL
Enumeration date
07/25/2013
Last updated
07/25/2013
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