Individual
PAUL J KRIVICKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 N. WESTMORELAND RD, LAKE FOREST, IL 60045
(312) 695-6868
Mailing address
680 N LAKE SHORE DR, CHICAGO, IL 60611
(312) 695-6868
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036122794
IL
207P00000X
Emergency Medicine Physician
4301087746
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036122794/1
—
IL
Enumeration date
05/11/2007
Last updated
09/18/2019
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