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Individual

MR. RENE GARCIA CANTU JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
CAPTAIN JAMES A. LOVELL FEDERAL HEALTH CARE CENTER, 3001 GREEN BAY ROAD, NORTH CHICAGO, IL 60064
(224) 610-7501
Mailing address
10816 E RIVIERA DR, SPRING GROVE, IL 60081-7813

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
12/08/2014
Last updated
11/30/2018
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