Cruz-Gonzalez, Wanda

Cruz-Gonzalez, Wanda is an sole proprietor health care provider with primary practice located at 2160 S First Ave 101 1740 Loyola University Medical Center, Maywood IL 60153. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is her primary health care specialty. Cruz-Gonzalez, Wanda can be contacted via phone (708) 216-9000.

Contact Information

Primary practice address
2160 S First Ave 101 1740 Loyola University Medical Center Maywood IL 60153
Phone: (708) 216-9000
Fax: (708) 216-9033
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 36055205 Illinois
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X Illinois

Profile Details

NPI number 1366416349
LBN Legal business name Cruz-Gonzalez, Wanda
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 15th, 2006
Last updated Mar 12th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366416349 NPPES
Illinois MEDICAID 36055205

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