Individual
KENNETH Q CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 W CENTRAL RD, ARLINGTON HEIGHTS, IL 60005-2349
(800) 655-2656
(412) 822-7411
Mailing address
830 WEST RTE 22, SUITE 50, LAKE ZURICH, IL 60047
(866) 344-0543
(866) 344-3934
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.100876
IL
207R00000X
Internal Medicine Physician
A90441
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A90441
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A904410
BLUE SHIELD OF CA
CA
05
—
00A904410
—
CA
Enumeration date
06/08/2006
Last updated
04/14/2025
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