Individual
DR. KENNETH A KREBS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
30 N MICHIGAN AVE, STE 822, CHICAGO, IL 60602-3805
(312) 332-3937
(312) 332-3929
Mailing address
30 N MICHIGAN AVE, STE 822, CHICAGO, IL 60602-3805
(312) 332-3937
(312) 332-3929
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19-013265
IL
1223P0300X
Periodontics
21-000664
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-013265
DENTAL LICENSE
IL
01
—
21-000664
SPECIALTY LICENSE
IL
Enumeration date
06/01/2005
Last updated
09/11/2025
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