Individual
ELLIOTT KROGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3210 GRAND AVE, WAUKEGAN, IL 60085-2204
(847) 220-4103
(847) 693-7029
Mailing address
PO BOX 746721, ATLANTA, GA 30374-6721
(313) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-059136
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-29526
EVERCARE
—
01
—
1982624763
BCBS OF IL
—
01
—
4932996
BCBS OF IL
—
Enumeration date
07/03/2006
Last updated
03/27/2023
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