Dr. Antonio B Cruz
General Practice Physician
1601 Tanglewood Suite 106
Hanover Park
, Illinois 60133
Dr. Antonio B Cruz
General Practice Physician
1601 Tanglewood Suite 106
Hanover Park
, Illinois 60133
(630) 289-9187
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Antonio B Cruz
- 1601 Tanglewood Suite 106
- Hanover Park, IL
- Zip : 60133
- Fax : (630) 289-9187
- Phone : (630) 289-7800
Second Address
- Dr. Antonio B Cruz
- 1601 Tanglewood Suite 106
- Hanover Park, IL
- Zip : 60133
- Fax : (630) 289-9187
- Phone : (630) 289-7800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | 636040977 | IL |
National Provider Identifier
| NPI | 1013013374 |
|---|---|
| Provider Name | Dr. Antonio B Cruz |
| First Address | Hanover Park, IL 60133 |
| Second Address | Hanover Park, IL 60133 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/09/2006 |
| Last Update Date | 17/10/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036040977 | (05) | IL |
| 362715536 | BCBS (01) | IL |
| D12147 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.