Richard C Krueger Jr., M.D., PH.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

G85014 Issued in CA

Practice address

2836 W 98TH PL
Evergreen Park, IL 60805-2613

Phone

(505) 506-1090

Fax

(888) 734-8467

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkrueger1311164@ahs.direct-ci.com
• Direct secure messaging: rkrueger2291864@direct.trinity-health.org
• Direct secure messaging: rkrueger@unionhealth.cernerdirect.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.

• Arnett Clinic, LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1164490843
  Medicare reassignment NPD
• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment NPD
• Arnett Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
  • NPI 1699839563
  NPD
• Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
  • NPI 1881655090
  NPD
• Union Hospital Inc.

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1619975331
  NPD
• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• St. Luke'S Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1548293954
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1497784862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 GENEVA ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062122",
            "telephone_number": "505-506-1090",
            "fax_number": "888-734-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 W 98TH PL",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052613",
            "telephone_number": "505-506-1090",
            "fax_number": "888-734-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NM",
            "license": "MD2006-0698",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036.084830",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WA",
            "license": "MD 60132358",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01069425A",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OK",
            "license": "28859",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2012003667",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MS",
            "license": "21987",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "G85014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201046030",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75929856",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000745199",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Goutham Kondapi
• Elizabeth R Konieczny
• Anne Koronkiewicz, DO
• Bahij Kreidieh
• Christopher Michael Krippinger, PA-C
• Krystal Michael PLLC
• Li-Mei Ku, D.C.
• Ryan Kukor, M.D.
• Kunhunn Vellody MD
• Kwanza Suites Corporation

• Neonatal-Perinatal Medicine Physician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Neonatal-Perinatal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.