Organization
ANTONIO B. CRUZ M.D.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO B. CRUZ M.D. (PRESIDENT)
(630) 289-7800
Entity
Organization
Contact information
Practice address
1601 TANGLEWOOD AVE STE 106, HANOVER PARK, IL 60133-3381
(630) 289-7800
(630) 289-9187
Mailing address
1601 TANGLEWOOD AVE STE 106, HANOVER PARK, IL 60133-3381
(630) 289-7800
(630) 289-9187
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
3640977
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036040977
—
IL
01
—
362175536
BCBS
IL
Enumeration date
07/18/2008
Last updated
10/17/2008
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