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General NPI Number Information
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NPI Number | 1720381726
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Entity Type | Individual
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Provider Name | TRACY ELLEN KRUGER CPNP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3232 LAKE AVE STE 330
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City | WILMETTE
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State | IL
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Zip | 60091-1085
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Country | US
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Telephone | 224-226-9420
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Fax | 847-256-2140
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 562732
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 041293414
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209-008621
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209-008621
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License Number State | IL
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