Provider Demographics
NPI:1013203660
Name:KREZALEK, MONIKA A (MD)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:A
Last Name:KREZALEK
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 1:757 PARK AVE W STE 2850
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2558
Mailing Address - Country:US
Mailing Address - Phone:847-570-1700
Mailing Address - Fax:847-503-4371
Practice Address - Street 1:757 PARK AVE W STE 2850
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2558
Practice Address - Country:US
Practice Address - Phone:847-570-1700
Practice Address - Fax:847-503-4371
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135316208600000X, 208C00000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery