Organization
CRESTWOOD MEDICAL ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO NORIEGA MD (PRESIDENT)
(708) 371-1190
Entity
Organization
Contact information
Practice address
13117 RIVERCREST DR, CRESTWOOD, IL 60418-4419
(708) 371-1190
(708) 448-8812
Mailing address
13117 RIVERCREST DR, CRESTWOOD, IL 60418-4419
(708) 371-1190
(708) 448-8812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036049076
—
IL
Enumeration date
06/08/2006
Last updated
01/09/2019
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