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Individual

DR. DIANE C. KRALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
105 S LOCUST ST, TREMONT, IL 61568-0187
(309) 925-2961
(309) 925-4221
Mailing address
105 S LOCUST ST, PO BOX 187, TREMONT, IL 61568-9572
(309) 925-2961
(309) 925-4221

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036111933
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9015656
BCBS
IL
01
P00253527
RAILROAD MEDICARE
IL
Enumeration date
09/20/2005
Last updated
05/15/2008
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