MEDICARE: MRS. WHITNEY LYNN KRUG L.C.P.C.

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	101YP2500X	Professional Counselor	180.005196	IL

General Provider Information

NPI Number	:	1942467832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WHITNEY LYNN KRUG L.C.P.C.

Provider Business Mailing Address
First Line	:	346 TAFT AVE
Second Line	:	#30
City	:	GLEN ELLYN
State	:	IL
Zip	:	60137-6296
Country	:	US
Telephone Number	:	630-690-3170
Fax Number	:

Provider Business Practice Location Address
First Line	:	346 TAFT AVE
Second Line	:	#30
City	:	GLEN ELLYN
State	:	IL
Zip	:	60137-6296
Country	:	US
Telephone Number	:	630-690-3170
Fax Number	:

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

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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