Individual
AMANDA KRUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1725 W HARRISON ST STE 1010, CHICAGO, IL 60612-3841
(312) 942-5904
Mailing address
910 W LAKE ST UNIT 2L, CHICAGO, IL 60607-1730
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006811
IL
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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