Provider Demographics
NPI:1326010570
Name:KRALL, ALLEN S (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:S
Last Name:KRALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VITAS HEALTHCARE
Mailing Address - Street 2:1801 PARK 270 DRIVE, SUITE 150
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146
Mailing Address - Country:US
Mailing Address - Phone:314-682-3400
Mailing Address - Fax:
Practice Address - Street 1:VITAS HEALTHCARE
Practice Address - Street 2:1801 PARK 270 DRIVE, SUITE 150
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146
Practice Address - Country:US
Practice Address - Phone:314-682-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-091534207RN0300X
MO2021033146207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-091534Medicaid
IL336-053087OtherIL CONTROLLED SUBSTANCE
IL336-053087OtherIL CONTROLLED SUBSTANCE
IL336-053087OtherIL CONTROLLED SUBSTANCE