Individual
STEPHANIE S KROGULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
363 FINANCIAL CT UNIT 300, ROCKFORD, IL 61107-6671
(815) 397-3691
Mailing address
4653 HIGH POINT DR APT 28, ROCKFORD, IL 61114-4822
(815) 601-4013
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020365
IL
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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