Healthcare Provider Details

I. General information

NPI: 1437558541
Provider Name (Legal Business Name): DANA KROOP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3924 W FULLERTON AVE
CHICAGO IL
60647-2228
US

IV. Provider business mailing address

2232 N CLYBOURN AVE FL 3
CHICAGO IL
60614-3193
US

V. Phone/Fax

Practice location:
  • Phone: 773-276-2229
  • Fax: 773-276-2190
Mailing address:
  • Phone: 312-633-5841
  • Fax: 773-269-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209-016054
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: