Individual
DR. ANTONIO NORIEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13117 RIVERCREST DR, CRESTWOOD, IL 60418-4419
(708) 371-1190
(708) 448-8812
Mailing address
13117 RIVERCREST DR, CRESTWOOD, IL 60418-4419
(708) 371-1190
(708) 448-8812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036049076
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21623955
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/05/2007
Last updated
01/09/2019
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