Individual
KRUPA MERCHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MS
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-3055
(312) 926-2000
Mailing address
251 E HURON ST, CHICAGO, IL 60611-3055
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
125080103
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2021
Last updated
06/07/2022
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