Individual provider Active NPI

Elizabeth Sarah Krolak, PNP

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1780955203
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209.005372 Issued in IL
Practice address
680 N Lake Shore Dr Ste 1050
Chicago, IL 60611-3054
Phone
(312) 642-5515
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209.005372 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr Ste 1050
Chicago, IL 60611-3054

Mailing address

1924 W Berenice Ave
Chicago, IL 60613-2722
Phone (773) 339-9065

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

LicenseStateTypeSpecialty
209.005372ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NWCP Pediatrics LLC PastSince Nov 6, 2022 Accepting new patients
Steven R Boas MD SC Past Accepting new patients
Children'S Asthma Respiratory & Exercise Specialists Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1780955203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 W BERENICE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132722",
            "telephone_number": "773-339-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1050",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113054",
            "telephone_number": "312-642-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLAK",
        "first_name": "ELIZABETH",
        "middle_name": "SARAH",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.005372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.