Whalio Doctors

NPI 1073501359

Jeremy L Krock, DO

Practitioner Anesthesiology Physician Peoria, IL

Practice location

Address
8600 N State Route 91 Suite 250, Peoria, IL 61615-9541
Phone
(309) 692-5393
Fax
(309) 692-2538

Registered specialties (3)

Anesthesiology Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 036093120 (IL)
Pain Medicine (Anesthesiology) Physician
Allopathic & Osteopathic Physicians Taxonomy 207LP2900X Licence 036093120 (IL)
Family Medicine Physician
Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 036093120 (IL)

Registry record

NPI
1073501359
Entity type
Individual
Sex (as registered)
Male
NPI issued
11 Oct 2005
Record last updated
3 Aug 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.