Individual
KRYS ELAN CAGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
666 DUNDEE RD STE 802, NORTHBROOK, IL 60062-2734
(847) 498-1515
Mailing address
114 GLENWOOD DR, ROUND LAKE BEACH, IL 60073-2624
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.387249
IL
363LF0000X
Family Nurse Practitioner
Primary
209.017230
IL
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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