Individual
MR. GEORGE J CLOUD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPA-C
Contact information
Practice address
6850 CENTENNIAL DR, TINLEY PARK, IL 60477-1653
(708) 429-3455
(708) 429-3422
Mailing address
6850 CENTENNIAL DR, TINLEY PARK, IL 60477-1653
(708) 429-3455
(708) 429-3422
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620925
BCBS
IL
Enumeration date
08/19/2006
Last updated
07/24/2008
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