Provider Demographics
NPI:1568492296
Name:KRYS, EDWARD MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MICHAEL
Last Name:KRYS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 S SPRING RD
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-3857
Mailing Address - Country:US
Mailing Address - Phone:800-862-5914
Mailing Address - Fax:
Practice Address - Street 1:477 S SPRING RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3857
Practice Address - Country:US
Practice Address - Phone:847-203-4534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-09-26
Deactivation Date:2022-04-21
Deactivation Code:
Reactivation Date:2022-11-21
Provider Licenses
StateLicense IDTaxonomies
IL042621272111N00000X
IL038008124111NI0900X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK38903Medicare PIN