Healthcare Provider Details

I. General information

NPI: 1750383485
Provider Name (Legal Business Name): MICHAEL THOMAS KRONON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 10/21/2024
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S. MAPLE AVE SUITE 2800
OAK PARK IL
60304
US

IV. Provider business mailing address

610 S. MAPLE AVE SUITE 2800
OAK PARK IL
60304
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-4120
  • Fax: 888-812-8191
Mailing address:
  • Phone: 312-563-4120
  • Fax: 312-563-4127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036092801
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number036-092801
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number036-092801
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number036-092801
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: