Provider Demographics
NPI:1003270588
Name:KROGH, KATRINA (MD)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:KROGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E CHICAGO AVE
Mailing Address - Street 2:WARD 3-140 W127
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4296
Mailing Address - Country:US
Mailing Address - Phone:312-503-8144
Mailing Address - Fax:312-503-8249
Practice Address - Street 1:251 E HURON ST STE 7-132I
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-7913
Practice Address - Fax:312-926-3127
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036148320207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology