Provider Demographics
NPI:1437558541
Name:KROOP, DANA (APRN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:KROOP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 N CLYBOURN AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3193
Mailing Address - Country:US
Mailing Address - Phone:312-633-5841
Mailing Address - Fax:773-269-5500
Practice Address - Street 1:3924 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2228
Practice Address - Country:US
Practice Address - Phone:773-276-2229
Practice Address - Fax:773-276-2190
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-016054363LF0000X, 363LF0000X
CT5871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid