Provider Demographics
NPI:1750383485
Name:KRONON, MICHAEL THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:THOMAS
Last Name:KRONON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:610 S. MAPLE AVE
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304
Mailing Address - Country:US
Mailing Address - Phone:312-563-4120
Mailing Address - Fax:312-563-4127
Practice Address - Street 1:610 S. MAPLE AVE
Practice Address - Street 2:SUITE 2800
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304
Practice Address - Country:US
Practice Address - Phone:312-563-4120
Practice Address - Fax:888-812-8191
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036092801208600000X
IL036-0928012086S0127X, 208G00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-092801-3Medicaid
ILK17385/357801Medicare ID - Type Unspecified
ILH68089Medicare UPIN