Individual
KENNETH R. KROCK
Active
Individual
KENNETH R. KROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036079829
IL
208000000X
Pediatrics Physician
036079829
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062839
UMWA
IL
01
—
013495
HEALTH ALLIANCE
IL
01
—
02922981
BCBS
IL
05
—
036079829
—
IL
01
—
079829
OSF HEALTHPLANS
IL
01
—
110200867
RR MEDICARE PIN
IL
01
—
180741
HEALTH LINK
IL
01
—
194215197
NPI CLINIC NUMBER
IL
01
—
200397
BLACK LUNG
IL
01
—
CG5172
RR MEDICARE GROUP#
IL
01
—
IL0104
JOHN DEERE
IL
Enumeration date
08/28/2006
Last updated
04/07/2021
Update your record
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