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Individual

ALBERTO DEJESUS CUARTAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3008 CIVIC CIRCLE BLVD, MARION, IL 62959-5262
(618) 993-1030
(618) 351-4009
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036098622
IL
207RX0202X
Medical Oncology Physician
036098622
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036098622
IL
01
10027291
BC/BS OF ILLINOIS
IL
Enumeration date
09/26/2006
Last updated
07/01/2024
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