Healthcare Provider Details

I. General information

NPI: 1942714183
Provider Name (Legal Business Name): LENA A KRAMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 09/08/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9711 SKOKIE BLVD STE J
SKOKIE IL
60077-1384
US

IV. Provider business mailing address

9711 SKOKIE BLVD STE J
SKOKIE IL
60077-1384
US

V. Phone/Fax

Practice location:
  • Phone: 847-675-9711
  • Fax: 847-675-9744
Mailing address:
  • Phone: 847-675-9711
  • Fax: 847-859-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: