Provider Demographics
NPI:1295846251
Name:KRAUSE, PHILIP B (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:B
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9650 GROSS POINT RD STE 4900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1214
Mailing Address - Country:US
Mailing Address - Phone:847-676-1333
Mailing Address - Fax:847-676-1727
Practice Address - Street 1:9650 GROSS POINT RD STE 4900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1214
Practice Address - Country:US
Practice Address - Phone:847-676-1333
Practice Address - Fax:847-676-1727
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036077928207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3607792Medicaid
ILF58290Medicare UPIN
IL212343Medicare ID - Type Unspecified