Individual provider Active NPI

Michael Thomas Kronon, MD

  • Vascular Surgery Physician
  • Oak Park, IL
National Provider Identifier
1750383485
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036-092801 Issued in IL
Practice address
610 S. Maple Ave
Suite 2800
Oak Park, IL 60304
Phone
(312) 563-4120
Fax
(888) 812-8191
NPI assigned
Aug 12, 2005
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036092801 IL
Trauma Surgery Physician 2086S0127X 036-092801 IL
Vascular Surgery Physician 2086S0129X 036-092801 IL Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036-092801 IL

Addresses

Primary practice location

610 S. Maple Ave
Suite 2800
Oak Park, IL 60304

Mailing address

610 S. Maple Ave
Suite 2800
Oak Park, IL 60304
Phone (312) 563-4120

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050524000532 IL Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic SurgeryPractitioner - Critical Care (Intensivists) 2365484029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036092801ILMDSurgery Physician
036-092801ILMDTrauma Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1750383485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S. MAPLE AVE",
            "address_2": "SUITE 2800",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60304",
            "telephone_number": "312-563-4120",
            "fax_number": "312-563-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S. MAPLE AVE",
            "address_2": "SUITE 2800",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60304",
            "telephone_number": "312-563-4120",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONON",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2024-10-21",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036092801",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036-092801",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036-092801",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036-092801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.