Active NPI
Pedro Carlos A Cruz, M.D.
- Internal Medicine Physician
- Phoenix, IL
National Provider Identifier
1740334663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Practice address
- 650 E. Phoenix Center Drive
Phoenix, IL 60426 - Phone
- (708) 225-9900
- Fax
- (708) 225-9997
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | IL | Primary |
Addresses
Primary practice location
650 E. Phoenix Center Drive
Phoenix, IL 60426
Mailing address
756 Buckingham CT
Carol Stream, IL 60188-4307
Phone (630) 213-5878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036083760 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1740334663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "756 BUCKINGHAM CT",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601884307",
"telephone_number": "630-213-5878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E. PHOENIX CENTER DRIVE",
"city": "PHOENIX",
"state": "IL",
"postal_code": "60426",
"telephone_number": "708-225-9900",
"fax_number": "708-225-9997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "PEDRO CARLOS",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.