Individual
MIGUEL CUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3412 W FULLERTON AVE, CHICAGO, IL 60647
(773) 235-8000
Mailing address
PO BOX 478499, FULLERTON KIMBALL MED GROUP, CHICAGO, IL 60647
(773) 235-8000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635426
BLUECROSS BLUESHIELD
IL
05
—
036060249 1
—
IL
Enumeration date
03/19/2007
Last updated
03/06/2008
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