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Individual

JEROME P KRAFT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5401 N KNOXVILLE AVE, SUITE 400, PEORIA, IL 61614-5098
(309) 692-6644
Mailing address
5401 N KNOXVILLE AVE, SUITE 400, PEORIA, IL 61614-5098
(309) 692-6644

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009013
HEALTH ALLIANCE
IL
01
141413
HEALTHLINK
IL
01
20004076
RR MEDICARE
IL
01
4281670001
DME
IL
01
7230175
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/30/2006
Last updated
07/08/2007
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