Active NPI
Christopher Joseph Krob, D.D.S
- Dentist
- La Grange Park, IL
National Provider Identifier
1568639706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019-021155
- Practice address
- 1103 E 31St St
La Grange Park, IL 60526-1280 - Phone
- (708) 579-5824
- Fax
- (708) 579-5199
- NPI assigned
- May 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-021155 | IL | Primary |
Addresses
Primary practice location
1103 E 31St St
La Grange Park, IL 60526-1280
Mailing address
1103 E 31St St
La Grange Park, IL 60526-1280
Phone (708) 579-5824
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-021155 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 1St Family Dental of la Grange Park, PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- La Grange Park, IL
- NPI 1154749240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262131200000",
"number": "1568639706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1103 E 31ST ST",
"city": "LA GRANGE PARK",
"state": "IL",
"postal_code": "605261280",
"telephone_number": "708-579-5824",
"fax_number": "708-579-5199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 E 31ST ST",
"city": "LA GRANGE PARK",
"state": "IL",
"postal_code": "605261280",
"telephone_number": "708-579-5824",
"fax_number": "708-579-5199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROB",
"first_name": "CHRISTOPHER",
"middle_name": "JOSEPH",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-15",
"last_updated": "2009-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-021155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Grange Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.