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:
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Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013013374 NPPES
Illinois Other 362715536 BCBS
Illinois MEDICAID 036040977 BCBS

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