Provider Demographics
NPI:1578682993
Name:KROCHMAL, DANIEL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:KROCHMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:401 N WABASH AVE UNIT 69B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3893
Mailing Address - Country:US
Mailing Address - Phone:312-847-1230
Mailing Address - Fax:312-753-3161
Practice Address - Street 1:230 E OGDEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2460
Practice Address - Country:US
Practice Address - Phone:312-847-1230
Practice Address - Fax:312-753-3161
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37371208600000X
IL036.1372862086S0122X, 2086S0122X
MI4301087654390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program