Kross, Jonathan Richard

Kross, Jonathan Richard is an individual health care provider with primary practice located at 12251 S 80Th Ave Ste 1630 , Palos Heights IL 60463-1256. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Kross, Jonathan Richard can be contacted via phone (630) 649-8972.

Contact Information

Primary practice address
12251 S 80Th Ave Ste 1630 Palos Heights IL 60463-1256
Phone: (630) 649-8972
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209.014337 Illinois

Profile Details

NPI number 1134579196
LBN Legal business name Kross, Jonathan Richard
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2016
Last updated Sep 19th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134579196 NPPES
Illinois Other F400410704 MEDICARE PTAN
Illinois MEDICAID 209014337001 MEDICARE PTAN

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