Provider Demographics
NPI:1336250554
Name:KRUSKOL, KRISTINA LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:LYNN
Last Name:KRUSKOL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4587 OLMSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-1181
Mailing Address - Country:US
Mailing Address - Phone:847-221-5064
Mailing Address - Fax:
Practice Address - Street 1:17W675 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3545
Practice Address - Country:US
Practice Address - Phone:630-620-2429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist