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Individual

DR. ANTONIO B CRUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1601 TANGLEWOOD, SUITE 106, HANOVER PARK, IL 60133
(630) 289-7800
(630) 289-9187
Mailing address
1601 TANGLEWOOD, SUITE 106, HANOVER PARK, IL 60133
(630) 289-7800
(630) 289-9187

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
636040977
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036040977
IL
01
362715536
BCBS
IL
Enumeration date
09/15/2006
Last updated
10/17/2008
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