Eden Jessica Kroin, MGCS, GC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

246-000474 Issued in IL

Practice address

1875 Dempster St Ste 285
Park Ridge, IL 60068-1157

Phone

(847) 723-7705

NPI assigned

Aug 27, 2018

Last updated

Dec 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1275014250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 285",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681157",
            "telephone_number": "847-723-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROIN",
        "first_name": "EDEN",
        "middle_name": "JESSICA",
        "credential": "MGCS, GC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "IL",
            "license": "246-000474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1875 Dempster St Ste 285",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "efaye217151@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 Dempster St Ste 285",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• KT Dental PC

• Genetic Counselor (M.S.) in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Genetic Counselor (M.S.) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.