Organization
KREG THERAPEUTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD POULOS (VICE PRESIDENT)
(312) 275-7006
Entity
Organization
Contact information
Practice address
2240 W WALNUT ST, CHICAGO, IL 60612-2218
(312) 829-8904
(312) 829-8909
Mailing address
2240 W WALNUT ST, CHICAGO, IL 60612-2218
(312) 829-8904
(312) 829-8909
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
203.000565
IL
Other
Enumeration date
12/01/2006
Last updated
09/26/2012
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