Basic Information
| Provider Information | |||||||||
| NPI: | 1053738385 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KROIN | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | V. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 N WESTMORELAND RD | ||||||||
| Address2: | |||||||||
| City: | LAKE FOREST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600451658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475358500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 N WESTMORELAND RD | ||||||||
| Address2: | |||||||||
| City: | LAKE FOREST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600451658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475358500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2014 | ||||||||
| LastUpdateDate: | 03/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 125065457 | IL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | A161234 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207XS0106X | 036-152997 | IL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No ID Information.