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General NPI Number Information
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NPI Number | 1376902908
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Entity Type | Individual
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Provider Name | DIANE KRAL FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 2773 SKOKIE VALLEY RD
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-1042
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Country | US
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Telephone | 847-986-0908
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 W DOBSON ST
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City | NILES
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State | IL
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Zip | 60714-4702
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Country | US
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Telephone | 773-206-7549
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209013840
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License Number State | IL
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