Individual
SAMUEL NATHAN KRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
780 MCARDLE DR STE A, CRYSTAL LAKE, IL 60014-8155
(779) 220-6262
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29915
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11829915
ALL COMMERCIAL PAYORS
IL
Enumeration date
04/19/2018
Last updated
12/11/2019
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