Provider Demographics
NPI:1487693685
Name:KRAMER, PAUL H (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:H
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:304 WAINWRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1900
Mailing Address - Country:US
Mailing Address - Phone:847-593-8460
Mailing Address - Fax:224-235-4652
Practice Address - Street 1:12840 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3327
Practice Address - Country:US
Practice Address - Phone:323-686-3045
Practice Address - Fax:224-235-4652
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL113713207RI0011X
CAG44030207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024663000Medicaid
KS100202640DMedicaid
MOMA1832002Medicare PIN
KS100202640DMedicaid