Provider Demographics
NPI:1346569563
Name:KRUCZEK, KIMBERLY R (DO)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:R
Last Name:KRUCZEK
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Gender:F
Credentials:DO
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Mailing Address - Street 1:27702 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1277
Mailing Address - Country:US
Mailing Address - Phone:708-862-7674
Mailing Address - Fax:708-862-1781
Practice Address - Street 1:19550 GOVERNORS HWY
Practice Address - Street 2:SUITE 3300
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2125
Practice Address - Country:US
Practice Address - Phone:708-915-8660
Practice Address - Fax:708-957-5919
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2016-04-12
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Provider Licenses
StateLicense IDTaxonomies
IL036.131755207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology