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Individual

KAMIL KRUKOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-6484
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101019677
MI
207Q00000X
Family Medicine Physician
63604-21
WI
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
63604
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1366703563
WI
Enumeration date
06/04/2012
Last updated
08/09/2023
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