MEDICARE: JEFFREY KROLL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	036087277	IL
2	207P00000X	Emergency Medicine Physician	73604-20	WI

General Provider Information

NPI Number	:	1134129521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY KROLL MD

Provider Business Mailing Address
First Line	:	9576 STATE HIGHWAY 70
Second Line	:
City	:	MINOCQUA
State	:	WI
Zip	:	54548-9067
Country	:	US
Telephone Number	:	815-295-9016
Fax Number	:

Provider Business Practice Location Address
First Line	:	9576 HIGHWAY 70
Second Line	:
City	:	MINOCQUA
State	:	WI
Zip	:	54548-9067
Country	:	US
Telephone Number	:	715-358-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	11/17/2022

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Directions to “ JEFFREY KROLL MD” Practice Location

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