Individual
JASON SCOTT KRAMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36100 N BROOKSIDE DR, SUITE 206, GURNEE, IL 60031-4571
(847) 856-2090
(847) 856-2093
Mailing address
225 N MILWAUKEE AVE, VERNON HILLS, IL 60061-4304
(847) 941-7600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036101800
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036101800
STATE LICENSE #
IL
01
—
04930316
BCBS PROVIDER #
IL
01
—
10593795
CAQH PROVIDER #
—
01
—
336062496
CONTROLLED SUBSTANCE #
IL
01
—
364456682
TAX IDENTIFICATION #
IL
Enumeration date
07/06/2006
Last updated
03/07/2023
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