De La Cruz, Rafael

De La Cruz, Rafael is an individual health care provider with primary practice located at 4 Memorial Dr Ste 230B , Alton IL 62002-6705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. De La Cruz, Rafael can be contacted via phone (636) 344-2014.

Contact Information

Primary practice address
4 Memorial Dr Ste 230B Alton IL 62002-6705
Phone: (636) 344-2014
Fax: (314) 747-1476
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 2008007441 Missouri
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 036-108921 Illinois

Profile Details

NPI number 1669460655
LBN Legal business name De La Cruz, Rafael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Feb 26th, 2021 - about 4 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 1669460655 NPPES
Missouri MEDICAID 1669460655

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