Provider Demographics
NPI:1326239591
Name:KREG THERAPEUTICS, INC.
Entity Type:Organization
Organization Name:KREG THERAPEUTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICARE BILLER SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:MAYORGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-829-8904
Mailing Address - Street 1:14200 WEST COMMERCE ROAD
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47334
Mailing Address - Country:US
Mailing Address - Phone:773-457-1408
Mailing Address - Fax:312-829-8909
Practice Address - Street 1:14200 WEST COMMERCE ROAD
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:IN
Practice Address - Zip Code:47334
Practice Address - Country:US
Practice Address - Phone:773-457-1408
Practice Address - Fax:312-829-8909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment