Provider Demographics
NPI:1619403052
Name:KROL, MATEUSZ (MD)
Entity Type:Individual
Prefix:
First Name:MATEUSZ
Middle Name:
Last Name:KROL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 CUMBERLAND TRL
Mailing Address - Street 2:APT D
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-1294
Mailing Address - Country:US
Mailing Address - Phone:224-698-7717
Mailing Address - Fax:
Practice Address - Street 1:580 CUMBERLAND TRL
Practice Address - Street 2:APT D
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-1294
Practice Address - Country:US
Practice Address - Phone:224-698-7717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program