Cruz, Antonio B
Cruz, Antonio B is an individual health care provider with primary practice located at 1601 Tanglewood Suite 106, Hanover Park IL 60133. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Cruz, Antonio B can be contacted via phone (630) 289-7800.Contact Information
Primary practice address
1601 Tanglewood Suite 106
Hanover Park IL 60133
Phone: (630) 289-7800
Fax: (630) 289-9187
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 636040977 | Illinois |
Profile Details
NPI number | 1013013374 |
---|---|
LBN Legal business name | Cruz, Antonio B |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 15th, 2006 |
Last updated | Oct 17th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1013013374 | NPPES |
Illinois | Other | 362715536 | BCBS |
Illinois | MEDICAID | 036040977 | BCBS |
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