Provider Demographics
NPI:1699353235
Name:KROL, AGNIESZKA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:KROL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23661 N CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-7415
Mailing Address - Country:US
Mailing Address - Phone:773-679-6501
Mailing Address - Fax:
Practice Address - Street 1:56 S MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-3108
Practice Address - Country:US
Practice Address - Phone:847-459-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.303269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist