Paul J Cruz

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036077364 Issued in IL

Practice address

3303 Logan Dr
Rea Clinic Herrin
Herrin, IL 62948

Phone

(618) 993-5767

Fax

(618) 724-2571

NPI assigned

Jan 13, 2006

Last updated

Oct 22, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1619956935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "address_2": "CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORP",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "62822",
            "telephone_number": "618-724-2401",
            "fax_number": "618-724-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 LOGAN DR",
            "address_2": "REA CLINIC HERRIN",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-993-5767",
            "fax_number": "618-724-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "PAUL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036077364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Cosimi, D.M.D., M.S.
• Erica Cowan, MSW
• Scott Wesley Cranick, PA-C
• Amy Creek-Koehn, LCPC
• Crossroads Home Care Services, LLC (Regional Hospice Marion)
• Maria Cull, PT
• Darrell Scott Cutler, PAC
• Brian K. Daines, M.D.
• Tracy Leanne Dalton, MS CCC-SLP
• Ruth Ann Daly, P.T.

• Obstetrics & Gynecology Physician in Herrin, IL
• Providers in Herrin, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.