Provider Demographics
NPI:1235208703
Name:JEFFREY KRAMER, M.D.S.C.
Entity Type:Organization
Organization Name:JEFFREY KRAMER, M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-567-2479
Mailing Address - Street 1:PO BOX 5184
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5184
Mailing Address - Country:US
Mailing Address - Phone:847-679-0629
Mailing Address - Fax:847-679-0630
Practice Address - Street 1:2525 S MICHIGAN AVE
Practice Address - Street 2:SUITE 817
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2315
Practice Address - Country:US
Practice Address - Phone:312-567-2479
Practice Address - Fax:312-328-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360529172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01621816OtherBLUE SHIELD
IL214234OtherMEDICARE GRP
IL036052917Medicaid
ILP00173714OtherRAILROAD MEDICARE
IL214234OtherMEDICARE GRP