Active NPI
Kelly Ann Kruger
- Private Vehicle
- Kinsman, IL
National Provider Identifier
1740524743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- K626-5017-8863
- Practice address
- 6605 S Kinsman Rd
Kinsman, IL 60437-4027 - Phone
- (815) 791-3996
- NPI assigned
- Nov 15, 2012
- Last updated
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | K626-5017-8863 | IL | Primary |
| Private Vehicle | 347C00000X | K626-5197-8080 | IL |
Addresses
Primary practice location
6605 S Kinsman Rd
Kinsman, IL 60437-4027
Mailing address
6605 S Kinsman Rd
PO Box 781
Kinsman, IL 60437-4027
Phone (815) 791-3996
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K626-5017-8863 | IL | MD | Private Vehicle |
| K626-5197-8080 | IL | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1740524743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6605 S KINSMAN RD",
"address_2": "PO BOX 781",
"city": "KINSMAN",
"state": "IL",
"postal_code": "604374027",
"telephone_number": "815-791-3996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6605 S KINSMAN RD",
"city": "KINSMAN",
"state": "IL",
"postal_code": "604374027",
"telephone_number": "815-791-3996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUGER",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "IL",
"license": "K626-5017-8863",
"primary": true
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "IL",
"license": "K626-5197-8080",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kinsman, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.