Bryan M Kruskol DO SC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

BRYAN M KRUSKOL DO SC

Practice address

1675 Bethany Rd
Suite C
Sycamore, IL 60178-3160

Phone

(815) 899-8080

Fax

(815) 899-8002

NPI assigned

Jul 9, 2006

Last updated

Dec 31, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bryan M Kruskol, DO

Title

Director Physician

Phone

(815) 899-8080

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1194758334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 BETHANY RD",
            "address_2": "SUITE C",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783160",
            "telephone_number": "815-899-8080",
            "fax_number": "815-899-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 BETHANY RD",
            "address_2": "SUITE C",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783160",
            "telephone_number": "815-899-8080",
            "fax_number": "815-899-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN M KRUSKOL DO SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "KRUSKOL",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR PHYSICIAN",
        "authorized_official_telephone_number": "815-899-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01932071",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broadstep Academy-Illinois Inc
• Erin Brodnick, M.S.
• Kristi L Brower, PSY.D.
• Brown Health LLC
• Cynthia Brown, PTA
• Allison Bucaro-Fink, PTA
• Hannah Buckle
• Katherine P. Burke, LMT, BCTMB
• Jay Burstein, M.D.
• Edwin Bush Jr., CHIROPRACTOR

• Obstetrics & Gynecology Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.