Individual
CARLOS CRUDUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19310 S HALSTED ST, GLENWOOD, IL 60425-1562
(708) 300-3132
(708) 300-3149
Mailing address
19310 S HALSTED ST, GLENWOOD, IL 60425-1562
(708) 300-3132
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-112800
IL
Other
Enumeration date
07/09/2006
Last updated
02/02/2016
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