Individual
MRS. KELLY ANN KRUGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6605 S KINSMAN RD, KINSMAN, IL 60437-4027
(815) 791-3996
Mailing address
6605 S KINSMAN RD, PO BOX 781, KINSMAN, IL 60437-4027
(815) 791-3996
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
K626-5017-8863
IL
347C00000X
Private Vehicle
K626-5197-8080
IL
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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