Individual
DR. RICHARD C KRUEGER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2836 W 98TH PL, EVERGREEN PARK, IL 60805-2613
(505) 506-1090
(888) 734-8467
Mailing address
712 GENEVA ST, GLENDALE, CA 91206-2122
(505) 506-1090
(888) 734-8467
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
01069425A
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
036.084830
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
2012003667
MO
2080N0001X
Neonatal-Perinatal Medicine Physician
21987
MS
2080N0001X
Neonatal-Perinatal Medicine Physician
28859
OK
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
G85014
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
MD 60132358
WA
2080N0001X
Neonatal-Perinatal Medicine Physician
MD2006-0698
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000745199
ANTHEM PROVIDER NUMBER
IN
05
—
201046030
—
IN
05
—
75929856
—
CA
Enumeration date
06/30/2006
Last updated
09/20/2022
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