| Doctor Name: | DR. ANTONIO B CRUZ |
| NPI Number: | 1013013374 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 636040977 |
| Business Practice Address: | 1601 Tanglewood Suite 106 Hanover Park, IL - 60133 |
| Business Phone Number: | 6302897800 |
| Business Fax Number: | 6302899187 |
| Mailing Address: | 1601 Tanglewood, Suite 106 HANOVER PARK |
| State: | IL |
| Postal Code: | 60133 |
| Phone Number: | 6302897800 |
| Fax Number: | 6302899187 |
| NPI Enumeration Date: | 09/15/2006 |
| NPI Last Update Date: | 10/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 636040977 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |