Individual
ROLANDO Y DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
248 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-8000
Mailing address
2122 PHILLIPS DR, GLENVIEW, IL 60026-1174
(847) 291-1437
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
35883
WI
208000000X
Pediatrics Physician
Primary
35883
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32076800
—
WI
Enumeration date
01/09/2007
Last updated
01/24/2017
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