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General NPI Number Information
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NPI Number | 1821326745
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Entity Type | Organization
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Legal Business Name | DAVID E KRAUSE MD LTD
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Dates
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Enumeration Date | 12/04/2009
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 475 BROWN BLVD STE 106
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City | BOURBONNAIS
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State | IL
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Zip | 60914-2325
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Country | US
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Telephone | 815-933-8020
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Fax | 815-933-8068
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Provider Business Mailing Address
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Address Line | 1022 DEER TRL
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City | BOURBONNAIS
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State | IL
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Zip | 60914-9338
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Country | US
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Telephone | 815-351-5912
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Fax | 815-933-8068
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | REBECCA BELL
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Credential |
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Telephone | 779-301-0975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 036061543
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License Number State | IL
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