| Antonio B. Cruz M.d.s.c. | |
|
1601 Tanglewood Ave Ste 106 Hanover Park IL 60133-3381 | |
| (630) 289-7800 | |
| (630) 289-9187 |
| Full Name | Antonio B. Cruz M.d.s.c. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1601 Tanglewood Ave Ste 106, Hanover Park, Illinois |
| Authorized Official Name and Position | Antonio B. Cruz (PRESIDENT) |
| Authorized Official Contact | 6302897800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antonio B. Cruz M.d.s.c. 1601 Tanglewood Ave Ste 106 Hanover Park IL 60133-3381 Ph: (630) 289-7800 | Antonio B. Cruz M.d.s.c. 1601 Tanglewood Ave Ste 106 Hanover Park IL 60133-3381 Ph: (630) 289-7800 |
| NPI Number | 1356506307 |
|---|---|
| Provider Enumeration Date | 07/18/2008 |
| Last Update Date | 10/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356506307 | NPI | - | NPPES |
| 036040977 | Medicaid | IL | |
| 362175536 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3640977 (Illinois) | Primary |
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