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Organization

PROGRESSIVE FAMILY HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN KROL M.D. (PRESIDENT)
(217) 875-9995
Entity
Organization

Contact information

Practice address
1110 ARBOR DR, SUITE D, DECATUR, IL 62526-9285
(217) 875-9995
Mailing address
1110 ARBOR DR, SUITE D, DECATUR, IL 62526-9285
(217) 875-9995

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
207Q00000X
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05822882
BLUE CROSS
IL
Enumeration date
04/17/2007
Last updated
07/28/2007
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