MEDICARE: DR. ALLEN S KRALL M.D.

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	207RN0300X	Nephrology Physician	036-091534	IL
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	2021033146	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	336-053087	OTHER	IL	IL CONTROLLED SUBSTANCE

General Provider Information

NPI Number	:	1326010570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN S KRALL M.D.

Provider Business Mailing Address
First Line	:	VITAS HEALTHCARE
Second Line	:	1801 PARK 270 DRIVE, SUITE 150
City	:	ST. LOUIS
State	:	MO
Zip	:	63146
Country	:	US
Telephone Number	:	314-682-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	VITAS HEALTHCARE
Second Line	:	1801 PARK 270 DRIVE, SUITE 150
City	:	ST. LOUIS
State	:	MO
Zip	:	63146
Country	:	US
Telephone Number	:	314-682-3400
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. ALLEN S KRALL M.D.” Practice Location

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