Individual
JAZZ DOMINIC KROEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 N RUTLEDGE ST STE 3100, SPRINGFIELD, IL 62702-4968
(217) 814-5178
(217) 757-6458
Mailing address
751 N RUTLEDGE ST STE 3100, SPRINGFIELD, IL 62702-4968
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.083662
IL
2085R0202X
Diagnostic Radiology Physician
Primary
125.083662
IL
Other
Enumeration date
05/27/2024
Last updated
08/14/2024
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