Kimberly R Kruczek, D.O

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

036.131755 Issued in IL

Practice address

19550 Governors Hwy
Suite 3300
Flossmoor, IL 60422-2125

Phone

(708) 915-8660

Fax

(708) 957-5919

NPI assigned

May 27, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Hematology/OncologyAlso: Internal Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ingalls Home Care Inc. Home health agency, Harvey, IL, CCN 147435
• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191
• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkruczek179472@uchospital.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ucm Medical Group Sub, LLC

  • Family Medicine Physician
  • Harvey, IL
  • NPI 1467442293

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation
• Ucm Home Care

  • Home Health Agency
  • Harvey, IL
  • NPI 1417998865
  Care Compare affiliation

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1346569563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731277",
            "telephone_number": "708-862-7674",
            "fax_number": "708-862-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 GOVERNORS HWY",
            "address_2": "SUITE 3300",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222125",
            "telephone_number": "708-915-8660",
            "fax_number": "708-957-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCZEK",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036.131755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale William Klooster, LCSW
• Rysa Shavonne Koch, M.A., LCPC
• Christopher Koenig, PA-C
• Kimberly Kramer, RD, LDN
• Margaret Krol, LCSW
• Lindsey Kulma, M.H.S., CCC-SLP/L
• John I Kung, M.D.
• Neal J Labana, MD
• Labcorp Testing
• Lake Anesthesia Associates

• Hematology & Oncology Physician in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Hematology & Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.