Provider Demographics
NPI:1992871347
Name:KRPAN, MARKO F (DO)
Entity type:Individual
Prefix:
First Name:MARKO
Middle Name:F
Last Name:KRPAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E CONGRESS PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-6248
Mailing Address - Country:US
Mailing Address - Phone:815-356-7494
Mailing Address - Fax:815-356-7541
Practice Address - Street 1:415 E CONGRESS PKWY STE A
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6248
Practice Address - Country:US
Practice Address - Phone:815-356-7494
Practice Address - Fax:815-356-7541
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-097251207XS0106X
WI38709207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097251 2Medicaid
WIKRPANMAROtherMERCYCARE INSURANCE
IL214660L76783Medicare PIN
IL036097251 2Medicaid