Pultorak, Kristine P

Pultorak, Kristine P is an individual health care provider with primary practice located at 403 E 1St St , Dixon IL 61021. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Pultorak, Kristine P can be contacted via phone (815) 288-5561.

Contact Information

Primary practice address
403 E 1St St Dixon IL 61021
Phone: (815) 288-5561
Fax: (815) 285-5859
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-092252 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036.092252 Illinois

Profile Details

NPI number 1306814298
LBN Legal business name Pultorak, Kristine P
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Nov 17th, 2022 - about 4 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 1306814298 NPPES
Illinois MEDICAID 036092252
Illinois Other 800200006
Illinois Other 381220005

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