Individual
DR. JENNIFER ANNE REGAN DELACRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-7400
(630) 933-4168
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-7400
(630) 933-4168
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125056188
IL
207RI0200X
Infectious Disease Physician
Primary
036132162
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036132162
MEDICAID
IL
01
—
206147
MEDICARE PTAN GROUP
IL
01
—
F400230237
MEDICARE PTAN INDIVIDUAL
IL
Enumeration date
05/13/2010
Last updated
09/17/2015
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