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NPI Code Detail

MEDICARE: KRISTINS KIDS INC

MEDICARE: KRISTINS KIDS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist036106744IL

General Provider Information

NPI Number : 1396982963
Entity Type Code : Organization
Provider Name (Legal Business Name) : KRISTINS KIDS INC
Provider Business Mailing Address
First Line : 55 E ERIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2798
Country : US
Telephone Number : 773-537-0020
Fax Number :
Provider Business Practice Location Address
First Line : 4733 N DAMEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-1442
Country : US
Telephone Number : 773-537-0020
Fax Number :
Authorized Official
Title or Position : NEUROLOGIST
Name : DR. DANIEL OROZCO
Credential : M.D.
Telephone Number : 773-537-0020
Provider Enumeration Date : 01/19/2009
Last Update Date : 01/19/2009

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Directions to “KRISTINS KIDS INC ” Practice Location

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